Long-term follow-up of first generation versus new-generation drug-eluting stents in three-vessel coronary artery disease.

Abstract

Few reports have primarily focused on long-term clinical outcomes in three-vessel disease when patients were treated with either first- or new-generation drug-eluting stents (DES). The purpose of this study was to investigate different clinical outcomes after percutaneous coronary intervention (PCI) for three-vessel disease with first- or new-generation DES. Between January 2007 and December 2013, a total of 200 patients who received complete revascularization of three-vessel disease with either first-generation DES (n=85) or new-generation DES (n=115) were analyzed in this retrospective study. Primary endpoint was the incidence of major adverse cardiac events (MACE) defined as composite endpoints of cardiac death, myocardial infarction, and target lesion revascularization at 3years. The event-free survival rate of MACE at 3years in the new-generation DES group was significantly higher than that in the first-generation group (62% vs. 77%, log rank p=0.02). The Cox regression multivariate analysis revealed that renal dysfunction [hazard ratio (HR): 2.14, 95% confidence interval (CI): 1.09-4.22; p=0.03], use of statins (HR: 0.54, 95% CI: 0.32-0.90; p=0.02) and first-generation DES (HR: 2.07, 95% CI: 1.22-3.49; p=0.01) were independent predictors of MACE. These findings indicated that in patients with three-vessel disease, PCI with new-generation DES is associated with a significantly increased event-free survival rate of MACE at 3years as compared to first-generation DES.