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首页> 中文期刊> 《老年心脏病学杂志（英文版）》 >Five-year clinical outcomes of first-generation versus second-generation drug-eluting stents following coronary chronic total occlusion intervention

Five-year clinical outcomes of first-generation versus second-generation drug-eluting stents following coronary chronic total occlusion intervention

         
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Background There are limited data comparing long-term clinical outcomes between first-generation（1G） and second-generation（ G） drug-eluting stents（DESs） in patients who underwent successful percutaneous coronary intervention（PCI） for coronary chronic total occlusion（CTO） lesion. Methods A total of 840 consecutive patients who underwent PCI with DESs for CTO lesion from January 2004 to November 2015 were enrolled. Finally, a total of 324 eligible CTO patients received 1G-DES（Paclitaxel-eluting stent or Sirolimus-eluting stent, n = 157） or 2G-DES（Zotarolimus-eluting stent or Everolimus-eluting stent, n = 167） were enrolled. The clinical endpoint was the occurrence of major adverse cardiac events（MACE） defined as all-cause death, recurrent myocardial infarction（re-MI）, total repeat revascularization [target lesion revascularization（TLR）, target vessel revascularization（TVR）, and non-TVR]. We investigated the 5-year major clinical outcomes between 1G-DES and 2G-DES in patient who underwent successful CTO PCI. Results After propensity score matched（PSM） analysis, two well-balanced groups（111 pairs, n = 222, C-statistic = 0.718） were generated. Up to the 5-year follow-up period, the cumulative incidence of all-cause death, re-MI, TLR, TVR and non-TVR were not significantly different between the two groups. Finally, MACE was also similar between the two groups（HR = 1.557, 95% CI: 0.820–2.959, P = 0.176） after PSM. Conclusions In this study, 2G-DES was not associated with reduced long-term MACE compared with 1G-DES following successful CTO revascularization up to five years.

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