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ȣ - 540321 146 |
Two-year Clinical Efficacy of Sirolimus- versus Paclitaxel- versus Zotarolimus-Eluting Stents in Diabetic Patients |
고려대학교 구로병원 순환기내과¹, 을지병원 심장내과², Cardiology Department, the Second Hospital of Tianjin Medical University, Tianjin, China³, Cardiology Department, Nankai Hospital, Tianjin Medical University, Tianjin, China⁴ |
나승운¹, Kanhaiya L. Poddar¹, Meera Kumari¹, 박지영², Sureshkumar Ramasamy¹, Kang Yin Chen³, Yong Jian Li⁴, 김연경¹, 나진오¹, 최철웅¹, 임홍의¹, 김진원¹, 김응주¹, 박창규¹, 서홍석¹, 오동주¹ |
Background: Drug-eluting stents (DESs) have drastically improved the angiographic and clinical outcomes of percutaneous coronary intervention (PCI) in patients (pts) with diabetes mellitus. However, little has been known whether the different types of DESs have similar efficacy in Asian diabetic pts.
Methods: A total of 305 diabetic pts who underwent PCI with Sirolimus (SES group; Cypher, n=102 pts, 247 lesions), Paclitaxel (PES group; Taxus, n=138 pts, 414 lesions) or Zotarolimus (ZES group; Endeavor, n=65 pts, 138 lesions)-eluting stents were enrolled. Angiographic ouotcomes at 6 months and cumulative clinical outcomes up to 2 years were compared among these 3 groups.
Results: These 3 groups had similar baseline clinical and procedural characteristics except that SES group had longer stent length and PES group had smaller stent diameter as compared with other groups. Six-month angiographic outcomes showed that SES group had less binary restenosis, lower restenosis percent, and late loss as compared with the other 2 groups. Major clinical outcomes were similar among the 3 groups up to 2 years except a trend toward lower incidence of TVR in SES group as compared with the other 2 groups. ZES group had 1 acute, 1 subacute, and 1 late stent thrombosis (ST), while the other 2 groups didn’t have ST throughout the follow-up period (Table).
Conclusions: Although SES had favorable angiographic outcomes at 6 months as compared with PES and ZES, these angiographic benefits were not translated into better clinical outcomes in patients with diabetes up to 2 years.
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Table: Six-month Angiographic and 2-year clinical outcomes
Variable, n (%) |
SES Group
(n=102 pts, 247 lesions) |
PES Group
(n=138 pts, 414 lesions) |
ZES Group
(n=65 pts, 138 lesions) |
P value |
Stent diameter, mm |
2.95 ± 0.36 |
2.86 ± 0.38 |
3.03 ± 0.44 |
<0.001 |
Stent length, mm |
26.87 ± 6.49 |
25.61 ± 7.08 |
24.10 ± 5.87 |
0.008 |
Binary restenosis |
12 (7.5) |
40 (15.9) |
16 (19.8) |
0.013 |
Restenosis percent, % |
19.45 ± 17.86 |
28.51 ± 21.93 |
32.44 ± 25.71 |
<0.001 |
Late loss, mm |
0.45 ± 0.49 |
0.85 ± 1.72 |
0.73 ± 0.69 |
0.008 |
Cardiac death |
2 (2.0) |
1 (0.7) |
1 (1.5) |
0.696 |
Q-wave MI |
0 (0) |
0 (0) |
0 (0) |
1.000 |
Non-Q-wave MI |
0 (0) |
0 (0) |
0 (0) |
1.000 |
TLR |
6 (5.9) |
16 (11.6) |
9 (13.8) |
0.190 |
TVR |
8 (7.8) |
22 (15.9) |
12 (18.5) |
0.092 |
TVR-MACE |
13 (12.7) |
25 (18.1) |
15 (23.1) |
0.218 |
Stent thrombosis |
0 (0) |
0 (0) |
3 (4.6) |
0.004 |
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