J Korean Med Sci.  2011 Oct;26(10):1299-1304. 10.3346/jkms.2011.26.10.1299.

Two-year Clinical Outcomes of Patients with Long Segments Drug-Eluting Stents: Comparison of Sirolimus-Eluting Stent with Paclitaxel-Eluting Stent

• Kim U
• Lee SH
• Hong GR
• Park JS
• Shin DG
• Kim YJ
• Jang JS
• Yang TH
• Kim DK
• Kim DS
• Kim DK
• Seol SH
• Kim DI
• Cho YK
• Kim HS
• Nam CW
• Hur SH
• Kim KB

• KMID: 1785986
• DOI: http://doi.org/10.3346/jkms.2011.26.10.1299

Abstract

Limited data are available on the long-term clinical efficacy of drug-eluting stent (DES) in diffuse long lesions. From May 2006 to May 2007, a total of 335 consecutive patients (374 lesions) were underwent percutaneous coronary intervention with implantation of long DES (> or = 30 mm) in real world practice. Eight-month angiographic outcomes and 2-yr clinical outcomes were compared between SES (n = 218) and PES (n = 117). Study endpoints were major adverse cardiac events including cardiac death, myocardial infarction, target-lesion revascularization, target-vessel revascularization and stent thrombosis. Baseline characteristics were similar in the two groups as were mean stent length (44.9 +/- 15.2 mm in SES and 47.4 +/- 15.9 in PES, P = 0.121). Late loss at 8 months follow-up was significantly lower in SES than in PES group (0.4 +/- 0.6 mm in SES vs 0.7 +/- 0.8 mm in PES, P = 0.007). Mean follow-up duration was 849 +/- 256 days, and 2-yr cumulative major adverse cardiac events were significantly lower in the SES than in the PES group (5.5% in SES vs 15.4% in PES, P = 0.003). In conclusion, long-term DES use in diffuse long coronary lesions is associated with favorable results, with SES being more effective and safer than PES in this real-world clinical experience.

Keyword

Drug-Eluting Stents; Long Lesion; Long-Term, Outcomes

MeSH Terms

Aged
Aged, 80 and over
Coronary Angiography
Coronary Artery Disease/*therapy
*Drug-Eluting Stents/adverse effects
Female
Follow-Up Studies
Humans
Male
Middle Aged
Paclitaxel/*administration & dosage/adverse effects
Sirolimus/*administration & dosage/adverse effects
Treatment Outcome

Figure

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  Fig. 1 Cumulative major adverse cardiac event (MACE) free survival is represented. Follow-up duration was 849 ± 256 days. The outcomes associated with sirolimuseluting stent (SES) use were better than those of paclitaxel-eluting stent (PES) use (93% in SES vs 85% in PES, P = 0.013).

• 

  Fig. 2 Target vessel revascularization-free survival rate is represented. The outcomes of sirolimus-eluting stent were better than those of paclitaxel-eluting stent (97% in SES vs 91% in PES, P = 0.014).

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  Fig. 3 Myocardial infarction, death and stent thrombosis free survival rate is represented. The outcomes of sirolimus-eluting stent were better than those of paclitaxeleluting stent (97% in SES vs 89% in PES, P = 0.002).

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