Effect of statin therapy on restenosis after coronary stent implantation

被引:126
作者
Walter, DH [1 ]
Schächinger, V [1 ]
Elsner, M [1 ]
Mach, S [1 ]
Auch-Schwelk, W [1 ]
Zeiher, AM [1 ]
机构
[1] Goethe Univ Frankfurt, Dept Internal Med 4, Div Cardiol, D-60590 Frankfurt, Germany
关键词
D O I
10.1016/S0002-9149(99)00910-8
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The effect of statins on the development of restenosis and clinical outcome after coronary stent implantation was assessed in a retrospective analysis of 525 consecutive patients. Baseline clinical, angiographic, and procedural characteristics did not differ between 258 patients with and 267 patients without statin therapy. Statin therapy was associated with a significantly (p <0.04) improved survival free of myocardial infarction and a significant reduction in repeat target vessel revascularization procedures (27.9% vs 36.7%, p <0.05) during 6-month follow-vp. Minimal lumen diameter was significantly larger (1.98 +/- 0.88 vs 1.78 +/- 0.88 mm, p = 0.01), late lumen loss was significantly less (0.64 +/- 0.8 vs 0.8 +/- 0.8 mm, p = 0.032), and net gain significantly increased (1.2 +/- 0.88 vs 0.98 +/- 0.92 mm, p = 0.009) in patients receiving statin therapy. Dichotomous angiographic restenosis (greater than or equal to 50%) rates were significantly lower, with 25.4% in the statin group compared with 38% in the no-statin group (p <0.005), Multivariate analysis identified statin therapy (p = 0.005), minimal lumen diameter immediately after stenting (p = 0.02), and stent length (p = 0.02) as independent predictors for subsequent restenosis development. Thus, statin therapy is associated with reduced recurrence rates and improved clinical outcome after coronary stent implantation. (C) 2000 by Excerpta Medica, Inc.
引用
收藏
页码:962 / 968
页数:7
相关论文
共 26 条
[1]   THE EFFECT OF CHOLESTEROL-LOWERING AND ANTIOXIDANT THERAPY ON ENDOTHELIUM-DEPENDENT CORONARY VASOMOTION [J].
ANDERSON, TJ ;
MEREDITH, IT ;
YEUNG, AC ;
FREI, B ;
SELWYN, AP ;
GANZ, P .
NEW ENGLAND JOURNAL OF MEDICINE, 1995, 332 (08) :488-493
[2]   Platelet-dependent thrombin generation in patients with hyperlipidemia [J].
Aoki, I ;
Aoki, N ;
Kawano, K ;
Shimoyama, K ;
Maki, A ;
Homori, M ;
Yanagisawa, A ;
Yamamoto, M ;
Kawai, Y ;
Ishikawa, K .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1997, 30 (01) :91-96
[3]   Predictors of restenosis after coronary stent implantation [J].
Bauters, C ;
Hubert, E ;
Prat, A ;
Bougrimi, K ;
Van Belle, E ;
McFadden, EP ;
Amouyel, P ;
Lablanche, JM ;
Bertrand, M .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1998, 31 (06) :1291-1298
[4]   Effect of pravastatin on angiographic restenosis after coronary balloon angioplasty [J].
Bertrand, ME ;
McFadden, EP ;
Fruchart, JC ;
VanBelle, E ;
Commeau, P ;
Grollier, G ;
Bassand, JP ;
Machecourt, J ;
Cassagnes, J ;
Mossard, JM ;
Vacheron, A ;
Castaigne, A ;
Danchin, N ;
Lablanche, JM .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1997, 30 (04) :863-869
[5]   Inhibitor of proliferation of arterial smooth-muscle cells by fluvastatin [J].
Corsini, A ;
Pazzucconi, F ;
Pfister, P ;
Paoletti, R ;
Sirtori, CR .
LANCET, 1996, 348 (9041) :1584-1584
[6]   Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels - Results of AFCAPS/TexCAPS [J].
Downs, JR ;
Clearfield, M ;
Weis, S ;
Whitney, E ;
Shapiro, DR ;
Beere, PA ;
Langendorfer, A ;
Stein, EA ;
Kruyer, W ;
Gotto, AM .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1998, 279 (20) :1615-1622
[7]  
Grundy SM, 1998, CIRCULATION, V97, P1436
[8]   Patterns and mechanisms of in-stent restenosis - A serial intravascular ultrasound study [J].
Hoffmann, R ;
Mintz, GS ;
Dussaillant, GR ;
Popma, JJ ;
Pichard, AD ;
Satler, LF ;
Kent, KM ;
Griffin, J ;
Leon, MB .
CIRCULATION, 1996, 94 (06) :1247-1254
[9]   Interlesion dependence of the risk for restenosis in patients with coronary stent placement in multiple lesions [J].
Kastrati, A ;
Schömig, A ;
Elezi, S ;
Schühlen, H ;
Wilhelm, M ;
Dirschinger, J .
CIRCULATION, 1998, 97 (24) :2396-2401
[10]   Predictive factors of restenosis after coronary stent placement [J].
Kastrati, A ;
Schomig, A ;
Elezi, S ;
Schuhlen, H ;
Dirschinger, J ;
Hadamitzky, M ;
Wehinger, A ;
Hausleiter, J ;
Walter, H ;
Neumann, FJ .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1997, 30 (06) :1428-1436