Real-world comparison of angiographic and 2-year clinical outcomes between first and second generation drug-eluting stents in patients received overlapping stents

Abstract

Background: There are few data comparing the efficacy of 1st and 2nd generation drug-eluting stents (DESs) in patients (pts) with long lesions who underwent percutaneous coronary intervention (PCI) by overlapping stenting. Methods: We compared mid-term angiographic and 2-year clinical outcomes of pts successfully treated with overlapping implantation of 1st generation DESs (DES-1; Cypher, Taxus, and Endeavor, n=1402) with 2nd generation DESs (DES-2; Xience V, Promus, Promus Element, Endeavor Resolute and Resolute Integrity, n=588) from June 2005 to January 2011. The pts with prior PCI and cardiogenic shock were excluded. Results: There were no significant differences in baseline clinical and lesion characteristics between the two groups except the DES-2 group had higher incidence in diabetes, multivessel disease, small vessel disease (>2.75mm in diameter), longer total lesion length, and higher stent numbers, whereas the DES-1 group had higher incidence of prior PCI, dyslipidemia, and cilostazol use. In multivariate logistic regression analysis, the incidence of binary restenosis, cardiac death, Q-wave myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), TLR- major cardiovascular event (MACE), and TVR-MACE were higher in the DES-1 group as compared with the DES-2 group (Table). ![Figure][1] Conclusions: In our study, the 2nd generations DESs were associated with superior efficacy and safety than 1st generation DESs in pts with diffuse long lesion undergoing overlapping stenting up to 2 years. [1]: pending:yes