Comparison of Different Types of Drug-Eluting Stents for De Novo Long Coronary Artery Lesions.
JACC Asia
; 2(4): 446-456, 2022 Aug.
Article
in En
| MEDLINE
| ID: mdl-36339368
ABSTRACT
Background:
Outcomes of percutaneous coronary intervention for diffuse long lesions remain relatively unfavorable. Prior clinical trials investigated the relative efficacy and safety of different types of drug-eluting stents (DES) in long lesions.Objectives:
This study sought to compare the relative performance of different types of DES for de novo long (≥25 mm) coronary artery lesions.Methods:
Using a pooled analysis of individual data of 1,450 patients from 3 randomized clinical trials, we compared angiographic and clinical outcomes of 5 different types of DES 224 patients with cobalt-chromium everolimus-eluting stents (EES), 255 with platinum-chromium EES, 250 with Resolute zotarolimus-eluting stents, 245 with biodegradable polymer biolimus-eluting stents, and 476 with first-generation sirolimus-eluting stents (SES). The primary endpoint was in-segment late lumen loss at 9 months.Results:
The primary endpoint was not significantly different between 4 second-generation DES and 1 first-generation SES (0.17 ± 0.41 mm in cobalt-chromium EES; 0.11 ± 0.37 in platinum-chromium EES 0.14 ± 0.38 in Resolute zotarolimus-eluting stents; 0.14 ± 0.38 in biodegradable polymer biolimus-eluting stents; or 0.10 ± 0.37 in SES, respectively, overall P = 0.38). Also, there were no significant between-group differences with respect to death, myocardial infarction, target-vessel revascularization, or stent thrombosis at 12 months. In the multiple treatment propensity-score analysis, the risk of angiographic and clinical outcomes was also similar among several types of DES.Conclusions:
In this patient-level pooled analysis, several second-generation DES showed similar angiographic and clinical outcomes in patients with de novo long coronary lesions. (Percutaneous Treatment of LONG Native Coronary Lesions With Drug-Eluting Stent-III [LONG-DES-III]; NCT01078038; Percutaneous Treatment of LONG Native Coronary Lesions With Drug-Eluting Stent-IV [LONG-DES-IV]; NCT01186094; and Everolimus-eluting [PROMUS-ELEMENT] vs. Biolimus A9-Eluting [NOBORI] Stents for Long-Coronary Lesions [LONG-DES-V]; NCT01186120).
BES, biolimus-eluting stent(s); DES, drug-eluting stent(s); EES, everolimus-eluting stent(s); MACE, major adverse cardiac event(s); MI, myocardial infarction; PCI, percutaneous coronary intervention; PtCr, platinum chromium; SES, sirolimus-eluting stent(s); TLR, target-lesion revascularization; TVR, target-vessel revascularization; coronary artery disease; drug-eluting stents; percutaneous coronary intervention
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Clinical_trials
Language:
En
Journal:
JACC Asia
Year:
2022
Document type:
Article
Affiliation country:
Corea del Sur