Comparison of Clinical Outcomes after Implantation of First- and Second-Generation Overlapping Drug-Eluting Stents to Treat Diffuse Long Coronary Lesions.
10.3904/kjm.2015.89.2.192
- Author:
Kyung Soo OH
1
;
Myung Ho JEONG
;
Jung Ae RHEE
;
Jin Su CHOI
;
Doo Hwan LEE
;
Jeong Hun KIM
;
Soo Hwan PARK
;
In Soo KIM
;
Dae Yong HYUN
;
Yun Ah JEONG
;
Hae Chang JEONG
;
Keun Ho PARK
;
Doo Sun SIM
;
Hyun Ju YOON
;
Kye Hun KIM
;
Hyung Uk PARK
;
Young Joon HONG
;
Youngkeun AHN
;
Jeong Gwan CHO
;
Jong Chun PARK
Author Information
1. The Heart Center of Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea. myungho@chollian.net
- Publication Type:Original Article
- Keywords:
Drug-eluting stents;
Percutaneous coronary intervention
- MeSH:
Coronary Stenosis;
Coronary Vessels;
Diabetes Mellitus;
Drug-Eluting Stents*;
Follow-Up Studies;
Humans;
Incidence;
Male;
Multivariate Analysis;
Percutaneous Coronary Intervention;
Stents;
Ventricular Dysfunction, Left;
Ventricular Function, Left
- From:Korean Journal of Medicine
2015;89(2):192-200
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Despite improved revascularization techniques, the clinical outcomes of patients with diffuse coronary artery lesions after percutaneous coronary intervention are unsatisfactory. However, few studies have compared the efficacy of first- and second-generation drug-eluting stents (DES) in patients with diffuse long coronary artery lesions. METHODS: Between January 2006 and July 2012, 364 patients who were treated with DES for long coronary artery stenosis (> 30 mm) were enrolled in this study and assigned to either Group I (first-generation DES, 62.3 +/- 10.4 years, 136 males, n = 183) or Group II (second-generation DES, 64.3 +/- 10.7 years, 134 males, n = 181). The incidence of major adverse cardiac events (MACE) was compared between the two groups over 2 years of follow-up, and predictive factors associated with MACE were evaluated through a multivariate analysis. RESULTS: Although several coronary angiographic characteristics were different between the two groups, most demographic and baseline clinical variables were the same. The cumulative incidence of MACE was significantly higher in Group I than in Group II (25.7 vs. 6.6%; p < 0.001), mainly due to reduced target lesion revascularization (21.9 vs. 2.2%; p < 0.001). According to the results of the multivariate analysis, the use of a paclitaxel-eluting stent (PES) (hazard ratio [HR], 5.168; 95% confidence interval [CI], 2.515-10.617; p < 0.001), decreased left ventricular function (< or = 45%; HR, 3.586; 95% CI, 1.839-6.990; p < 0.001), and diabetes mellitus (HR, 2.984; 95% CI, 1.605-5.548; p < 0.001) were independent contributors to MACE. CONCLUSIONS: For patients with diffuse long coronary artery stenosis, the use of second-generation DES improved the clinical outcome compared with first-generation DES. In addition, the use of a PES, left ventricular dysfunction, and diabetes were predictors of MACE after overlapping stenting.
