Two-year clinical outcomes of patients with overlapping second-generation drug-eluting stents for treatment of long coronary artery lesions: comparison of everolimus-eluting stents with resolute zotarolimus-eluting stents.

Abstract

OBJECTIVE:

The aim of this study was to compare the 2-year clinical outcomes of overlapping second-generation everolimus-eluting stents (EES) with those of overlapping resolute zotarolimus-eluting stents (R-ZES) in the treatment of long coronary artery lesions.

MATERIALS AND METHODS:

This retrospective analysis included 256 patients treated with overlapping EES (n=121) and R-ZES (n=135) for long coronary artery lesions (total stent length per lesion ≥34 mm). Study endpoints included major adverse cardiac events (MACE) defined as the composite of cardiac death, myocardial infarction, and target-vessel revascularization (TVR), as well as target-lesion revascularization and definite stent thrombosis separately at 2 years.

RESULTS:

In the two groups, the mean age was older and the average number of disease vessel was higher in the R-ZES group. The mean lesion length and total stent length per lesion were longer in the R-ZES group. EES were more frequently implanted in the left anterior descending coronary artery. No significant differences in the estimated MACE (5.8% for EES vs. 8.1% for R-ZES; P=0.548) or TVR (3.4% for EES vs. 4.0% for R-ZES; P=0.806) rates were noted between the two groups at 2-year follow-up. The incidence of definite stent thrombosis was low and similar in both groups (0.83% for EES vs. 0% for R-ZES; P=0.473). No significant differences were noted with respect to MACE or TVR between the two groups following propensity score matching.

CONCLUSION:

Stent overlap with second-generation EES or R-ZES was associated with low rates of MACE, TVR, and stent thrombosis at 2-year follow-up. Our results suggest that the use of overlapping EES or R-ZES in long coronary lesions is associated with good long-term clinical outcomes. These results need to be validated with randomized controlled trials.

• Authors: Xiao-tao Li, Hao Sun, Da-peng Zhang, Li Xu, Zhu-hua Ni, Kun Xia, Yu Liu, Yong-hui Chi, Ji-fang He, Wei-ming Li, Hong-shi Wang, Le-feng Wang, Xin-chun Yang
• Journal: Coronary artery disease (Coron Artery Dis) Vol. 25 Issue 5 Pg. 405-11 (Aug 2014) ISSN: 1473-5830 [Electronic] England
• PMID: 24584031 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Cardiovascular Agents
• Everolimus
• zotarolimus
• Sirolimus

Topics

• Aged
• Cardiovascular Agents (administration & dosage)
• Chi-Square Distribution
• Coronary Artery Disease (diagnosis, mortality, therapy)
• Coronary Thrombosis (etiology, mortality)
• Drug-Eluting Stents
• Everolimus
• Female
• Humans
• Kaplan-Meier Estimate
• Logistic Models
• Male
• Middle Aged
• Myocardial Infarction (etiology, mortality)
• Percutaneous Coronary Intervention (adverse effects, instrumentation, mortality)
• Propensity Score
• Proportional Hazards Models
• Prosthesis Design
• Retrospective Studies
• Risk Factors
• Sirolimus (administration & dosage, analogs & derivatives)
• Time Factors
• Treatment Outcome