1.Long-term Clinical Outcomes of Firstand Second-Generation Drug-Eluting Stents in Patients With Single-Vessel Disease: 10-Year Follow-Up Results From a Korean Single-Center Registry
Jae Kyeong BYUN ; Se Yeon CHOI ; Seung-Woon RHA ; Byoung Geol CHOI ; Jinah CHA ; Su Jin HYUN ; You Jin LEE ; Manda Satria CHESARIO ; Melly SUSANTI ; Soohyung PARK ; Eun Jin PARK ; Dong Oh KANG ; Cheol Ung CHOI ; Chang Gyu PARK ; Dong Joo OH
Journal of Cardiovascular Intervention 2026;5(1):49-59
Background:
There are limited long-term clinical outcome data comparing first-generation (1G) versus second-generation (2G) drug-eluting stents (DES) in patients with single-vessel disease (SVD). We sought to compare the efficacy and safety of 1G- and 2G-DES in SVD patients who underwent successful percutaneous coronary intervention (PCI) over 10 years of clinical follow-up.
Methods:
A total of 2,312 consecutive patients with SVD who underwent PCI with 1G-DES (paclitaxel- or sirolimus-eluting stents, n = 811) or 2G-DES (zotarolimus [Endeavor, Endeavor Resolute]- or everolimus-eluting stents [Promus Element, Xience], n = 1,082) were enrolled.After propensity score matching, 2 matched groups (538 pairs) were generated. Study endpoints included individual and composite clinical outcomes through 10 years.
Results:
During the 10-year follow-up, the 2G-DES group had lower incidences of myocardial infarction (MI; hazard ratio [HR], 0.44; 95% confidence interval [CI], 0.22–0.92; P = 0.028) and target lesion revascularization (TLR; HR, 0.54; 95% CI, 0.32–0.91; P = 0.021) than the 1G-DES group. Rates of total death, cardiac death, non-target vessel revascularization, stroke, major adverse cardiac events, and major adverse cardiac and cerebrovascular events were similar between groups.
Conclusions
In our single-center, all-comer registry, 2G-DES were associated with lower incidence rates of MI and TLR compared to 1G-DES in SVD patients over 10 years of followup, indicating a safer and more durable effect than 1G-DES.
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