Background: Percutaneous coronary intervention (PCI) of diffuse long coronary artery lesions remains still challenging in drug-eluting stent (DES) era. The aim of this study is to compare clinical outcomes between 1st generation and 2nd generation DES in diffuse long lesions.
Methods: From May 2006 to June 2009, a total of 527 consecutive patients (575 lesions) were underwent PCI with implantation of long DES (≥ 30mm) in real world practice. Eight-month angiographic outcomes and one-year clinical outcomes were compared between patients who received 1st generation Sirolimus and Paclitaxel-eluting stent (Group 1, n=335) and 2nd Generation Zotarolimus and Everolimus-eluting stent (Group 2, n=192). Study outcomes were major adverse cardiac events (MACE) including cardiac death, myocardial infarction (MI), target-lesion revascularization (TLR), target-vessel revascularization (TVR) and stent thrombosis (ST).
Results: Baseline characteristics between two groups were similar. Mean lesion length was 41.6±14.9 mm in Group 1 and 42.6±15.2 mm in Group 2 (p=0.163). Angiographic follow-up at 8 month was performed in 47%. Binary restenosis was 6.8% in Group 1 and 12.4% in Group 2 (p=0.117). Cumulative MACE showed similar (6.9% in Group 1 vs. 5.7% in Group 2, p=0.609) but, the rates of MI were higher in Group 1 than those of Group 2 (3.0% in Group 1 vs. 0% in Group 2, p=0.017).
Conclusion: DES in diffuse long coronary lesion has acceptable low rates of clinical events, the rates of MI seem to be higher in 1st generation DES than those of 2nd generation DES.
Key Words: Drug-eluting stent; Long lesion; Outcomes; New generation
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