Five-year clinical outcomes of first-generation versus second-generation drug-eluting stents following coronary chronic total occlusion intervention

Yong Hoon Kim, Ae Young Her, Seung Woon Rha, Byoung Geol Choi, Se Yeon Choi, Jae Kyeong Byun, Yoonjee Park, Dong Oh Kang, Won Young Jang, Woohyeun Kim, Ju Yeol Baek, Woong Gil Choi, Tae Soo Kang, Jihun Ahn, Sang Ho Park, Ji Young Park, Min Ho Lee, Cheol Ung Choi, Chang Gyu Park, Hong Seog Seo

Research output: Contribution to journalArticle

Abstract

Background There are limited data comparing long-term clinical outcomes between first-generation (1G) and second-generation (2G) drug-eluting stents (DESs) in patients who underwent successful percutaneous coronary intervention (PCI) for coronary chronic total occlusion (CTO) lesion. Methods A total of 840 consecutive patients who underwent PCI with DESs for CTO lesion from January 2004 to November 2015 were enrolled. Finally, a total of 324 eligible CTO patients received 1G-DES (Paclitaxel-eluting stent or Sirolimus-eluting stent, n = 157) or 2G-DES (Zotarolimus-eluting stent or Everolimus-eluting stent, n = 167) were enrolled. The clinical endpoint was the occurrence of major adverse cardiac events (MACE) defined as all-cause death, recurrent myocardial infarction (re-MI), total repeat revascularization [target lesion revascularization (TLR), target vessel revascularization (TVR), and non-TVR]. We investigated the 5-year major clinical outcomes between 1G-DES and 2G-DES in patient who underwent successful CTO PCI. Results After propensity score matched (PSM) analysis, two well-balanced groups (111 pairs, n = 222, C-statistic = 0.718) were generated. Up to the 5-year follow-up period, the cumulative incidence of all-cause death, re-MI, TLR, TVR and non-TVR were not significantly different between the two groups. Finally, MACE was also similar between the two groups (HR = 1.557, 95% CI: 0.820–2.959, P = 0.176) after PSM. Conclusions In this study, 2G-DES was not associated with reduced long-term MACE compared with 1G-DES following successful CTO revascularization up to five years.

Original languageEnglish
Pages (from-to)639-647
Number of pages9
JournalJournal of Geriatric Cardiology
Volume16
Issue number8
DOIs
Publication statusPublished - 2019 Jan 1

Keywords

  • Chronic total occlusion
  • Drug-eluting stent
  • Outcomes

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Cardiology and Cardiovascular Medicine

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