Acute and Long-Term Angiographic Outcomes of Side Branch Stenosis after Randomized Treatment of Zotarolimus-, Sirolimus-, and Paclitaxel-Eluting Stent for Coronary Artery Stenosis.
10.3346/jkms.2012.27.12.1499
- Author:
Bong Ki LEE
1
;
Young Hak KIM
;
Duk Woo PARK
;
Sung Cheol YUN
;
Jung Min AHN
;
Hae Geun SONG
;
Jong Young LEE
;
Won Jang KIM
;
Soo Jin KANG
;
Seung Whan LEE
;
Cheol Whan LEE
;
Jae Hwan LEE
;
In Whan SEONG
;
Seong Wook PARK
;
Seung Jung PARK
Author Information
1. Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Kangwon National University Hospital, Chuncheon, Korea.
- Publication Type:Original Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
- Keywords:
Drug-Eluting Stents;
Bifurcation;
Percutaneous Coronary Intervention;
Zotarolimus;
Sirolimus;
Paclitaxel
- MeSH:
Acute Disease;
Aged;
Blood Vessels/physiopathology;
Cardiovascular Agents/*therapeutic use;
Coronary Angiography;
Coronary Stenosis/*drug therapy/physiopathology/radiography;
Drug-Eluting Stents/*adverse effects;
Female;
Follow-Up Studies;
Humans;
Logistic Models;
Male;
Middle Aged;
Myocardial Infarction/etiology/radiography;
Myocardial Revascularization;
Odds Ratio;
Paclitaxel/*therapeutic use;
Predictive Value of Tests;
Sirolimus/*analogs & derivatives/*therapeutic use;
Thrombosis/etiology;
Treatment Outcome
- From:Journal of Korean Medical Science
2012;27(12):1499-1506
- CountryRepublic of Korea
- Language:English
-
Abstract:
This was designed to assess the outcomes of side branch (SB) stenosis after implantation of three drug-eluting stents (DES). From 2,645 patients in the ZEST (Comparison of the Efficacy and Safety of Zotarolimus-Eluting Stent with Sirolimus-Eluting and PacliTaxel-Eluting Stent for Coronary Lesions) Trial, 788 patients had 923 bifurcation lesions with SB > or = 1.5 mm were included. SB was treated in 150 lesions, including 35 (3.8%) receiving SB stenting. Of untreated SB with baseline stenosis < 50%, the incidences of periprocedural SB compromise was similar in the zotarolimus (15.8%), sirolimus (17.2%), and paclitaxel (16.6%) stent groups (P = 0.92). At follow-up angiography, delayed SB compromise occurred in 13.9%, 3.2%, and 9.4% (P = 0.010) of these groups. When classified into four groups (< 50%, 50%-70%, 70%-99%, and 100%), 9.0% of untreated SB were worsened, whereas improvement and stationary were observed in 9.6% and 81.4%. In a multivariable logistic regression model, main branch (MB) stenosis at follow-up (%) was the only independent predictor of SB stenosis worsening (odds ratio, 1.03; 95% confidence interval, 1.01-1.04; P < 0.001). After MB stenting in bifurcation lesions, a minority of SB appears to worsen. DES with strong anti-restenotic efficacy may help maintain SB patency.
