Five-year outcomes after first- and second-generation drug-eluting stent implantation in all patients undergoing percutaneous coronary intervention. Issue 2 (August 2019)

• Record Type: Journal Article
• Authors: Yano, Hideki; Horinaka, Shigeo; Watahiki, Manami; Watanabe, Tomoko; Ishimitsu, Toshihiko
• Is Part Of: Journal of cardiology. Volume 74:Issue 2(2019)
• Page Start: 169
• Page End: 174
• Publication Date: 2019-08
• Subjects: Everolimus-eluting stent -- Sirolimus-eluting stent -- Major adverse cardiac events -- Stent thrombosis; Cardiology -- Periodicals; 616.12
• DOI: 10.1016/j.jjcc.2019.01.012
• Languages: English
• ISSNs: 0914-5087

Abstract

Highlights: At 5 years, target lesion revascularization was significantly lower in the everolimus-eluting stent (EES) group than in the sirolimus-eluting stent (SES) group. The rate of stent thrombosis was significantly less in the EES group than in the SES group. Hemodialysis and the type of stent were independent risk factors for primary outcome. EES offers a safe and effective treatment throughout 5 years. Abstract: Background: Use of the everolimus-eluting stent (EES) instead of the sirolimus-eluting stent (SES) has been shown to improve clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) out to 3 years. However, it is not known whether the differences in efficacy and safety outcomes remain constant throughout 5 years. Methods: This was a retrospective, non-randomized, observational study. We followed 1460 consecutive patients undergoing PCI in our institutions from April 2005 to March 2012. There were 718 cases in patients with SES (SES group) and 742 with EES (EES group). Ten-month angiographic follow-up results and 5-year clinical follow-up outcomes were compared between the EES and SES groups. The primary outcome of this study was major adverse cardiac events (MACE), defined as the composite of cardiac death, recurrent myocardial infarction (MI), target vessel revascularization (TVR), and stent thrombosis (ST). Results: At 5 years, the rates of target lesion revascularization (TLR), TVR, recurrent MI and ST were significantly lower in the EES group compared to the SES group (TLR: 4.6% vs. 8.2%, p < 0.05; TVR: 5.0% vs. 9.0%, p < 0.05; recurrent MI: 1.5% vs. 4.4%, p < 0.05; ST: 1.2% vs. 3.9%, p < 0.05). Thus, MACE were significantly lesser in the EES group compared to the SES group (8.8% vs. 12.8%, p = 0.006). Conclusions: EES improved clinical outcomes compared to SES, and specifically, was associated with reductions in TVR, ST, and recurrent MI out to 5 years.