Korean Circ J.  2019 Aug;49(8):709-720. 10.4070/kcj.2019.0018.

Effectiveness and Safety of Zotarolimus-Eluting Stent (Resoluteâ„¢ Integrity) in Patients with Diffuse Long Coronary Artery Disease

• Park KH
• Ahn Y
• Koh YY
• Ki YJ
• Kim SS
• Kim HK
• Choi DH
• Hong YJ
• Hwang JY
• Kim DH
• Rhew JY
• Ryu JK
• Park JS
• Park TH
• Yang TH
• Oh SK
• Lee BR
• Lee SU
• Lee SG
• Chun KJ
• Cho JH
• Cha KS
• Chae JK
• Hur SH
• Hwang SH
• Park HS
• Kim DI

• KMID: 2456865
• DOI: http://doi.org/10.4070/kcj.2019.0018

Abstract

BACKGROUND AND OBJECTIVES
Diffuse long coronary artery disease (DLCAD) still has unfavorable clinical outcomes after successful percutaneous coronary intervention (PCI). Therefore, we aimed to evaluate the effectiveness and safety of Resoluteâ„¢ zotarolimus-eluting stent (R-ZES; Resoluteâ„¢ Integrity) for patients with DLCAD.
METHODS
From December 2011 to December 2014, 1,011 patients who underwent PCI using R-ZES for CAD with longer than 25 mm lesion were prospectively enrolled from 21 hospitals in Korea. We assessed the clinical outcome of major adverse cardiac events (MACE) defined as the composite of cardiac death, non-fatal myocardial infarction (MI), and clinically-driven target vessel revascularization at 12 months.
RESULTS
Mean age was 63.8±10.8 years, 701 (69.3%) patients were male, 572 (87.0%) patients had hypertension, 339 (33.8%) patients had diabetes, 549 (54.3%) patients diagnosed with acute MI and 545 (53.9%) patients had multi-vessel disease (MVD). A total of 1,697 stents were implanted into a total of 1,472 lesions. The mean diameter was 3.07±0.38 mm and the length was 28.27±6.97 mm. Multiple overlapping stents were performed in 205 (13.8%) lesions. A 12-month clinical follow-up was available in 1,004 patients (99.3%). The incidences of MACE and definite stent thrombosis at 12-month were 3.0% and 0.3% respectively. On multivariate Cox-regression analysis, multiple overlapping stents implantation, previous congestive heart failure, MVD, and age ≥75 years were independent predictors of one-year MACE.
CONCLUSIONS
Our study shows that R-ZES has an excellent 1-year clinical outcome in Korean patients with DLCAD.

Keyword

Drug-eluting stents; Coronary artery disease; Treatment outcome

MeSH Terms

Coronary Artery Disease*
Coronary Vessels*
Death
Drug-Eluting Stents
Follow-Up Studies
Heart Failure
Humans
Hypertension
Incidence
Korea
Male
Myocardial Infarction
Percutaneous Coronary Intervention
Prospective Studies
Stents*
Thrombosis
Treatment Outcome

Figure

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  Figure 1 Kaplan-Meier survival curves for MACE among subgroups. Cumulative incidences of MACE according to (A) sex, (B) the presence of DM, (C) presentation with AMI, (D) performance of post-dilatation, (E) use of IVUS, and (F) the presence of multiple overlapping stents implantation. AMI = acute myocardial infarction; DM = diabetes mellitus; IVUS = intravascular ultrasound MACE = major adverse cardiac events.

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