Long-term clinical outcomes of overlapping heterogeneous drug-eluting stents compared with homogeneous drug-eluting stents

Heart. 2011 Sep;97(18):1501-6. doi: 10.1136/hrt.2011.226308. Epub 2011 Jun 30.

Abstract

Objectives: To evaluate long-term clinical outcomes of overlapping heterogeneous drug-eluting stents (DES) compared with homogeneous DES.

Design and setting: The catholic medical centre coronary intervention database is a multicentre database of percutaneous coronary intervention with DES. This database contains data on consecutive patients from eight coronary intervention centres in Korea.

Patients: Overlapping homogeneous DES were used in 940 patients and overlapping heterogeneous DES in 140 patients between January 2005 and June 2010.

Intervention: The study enrolled patients with one-vessel disease treated with two overlapping DES in one lesion.

Main outcome measures: The study end point was the occurrence of major adverse cardiac events (MACE), defined as cardiac death, myocardial infarction (MI) or target lesion revascularisation (TRL).

Results: The two patient groups had similar baseline clinical and angiographic characteristics. MACE, cardiac death, MI and TRL rates, were not significantly different between the homogeneous and heterogeneous DES groups (9.9% vs 11.4%, p=0.574; 2.7% vs 3.6%, p=0.578; 1.5% vs 1.4%, p=1.000; 5.7% vs 6.4%, p=0.747, respectively). In addition, it was found that overlap with second-generation DES may be safe and effective, and the sirolimus-eluting stent (SES)+SES group had higher rate of MACE-free survival than the paclitaxel-eluting stent (PES)+PES group (p=0.014).

Conclusions: Overlapping heterogeneous DES and overlapping homogeneous DES had similar long-term safety and efficacy outcomes.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Coronary Angiography
  • Coronary Disease / therapy*
  • Coronary Restenosis
  • Databases, Factual
  • Drug-Eluting Stents*
  • Equipment Design
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Treatment Outcome