Five-year outcomes of biodegradable versus second-generation durable polymer drug-eluting stents used in complex percutaneous coronary intervention
| Title: | Five-year outcomes of biodegradable versus second-generation durable polymer drug-eluting stents used in complex percutaneous coronary intervention |
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| Authors: | Na Xu, Lin Jiang, Yi Yao, Jingjing Xu, Ru Liu, Huanhuan Wang, Ying Song, Lijian Gao, Zhan Gao, Xueyan Zhao, Bo Xu, Yaling Han, Jinqing Yuan, Rongman Jia, Xiuyuan Hao |
| Source: | Chinese Medical Journal, Vol 136, Iss 3, Pp 322-330 (2023) |
| Publisher Information: | Wolters Kluwer, 2023. |
| Publication Year: | 2023 |
| Collection: | LCC:Medicine |
| Subject Terms: | Medicine |
| More Details: | Abstract. Background:. There are few data comparing clinical outcomes of complex percutaneous coronary intervention (CPCI) when using biodegradable polymer drug-eluting stents (BP-DES) or second-generation durable polymer drug-eluting stents (DP-DES). The purpose of this study was to investigate the safety and efficacy of BP-DES and compare that with DP-DES in patients with and without CPCI during a 5-year follow-up. Methods:. Patients who exclusively underwent BP-DES or DP-DES implantation in 2013 at Fuwai Hospital were consecutively enrolled and stratified into two categories based on CPCI presence or absence. CPCI included at least one of the following features: unprotected left main lesion, ≥2 lesions treated, ≥2 stents implanted, total stent length >40 mm, moderate-to-severe calcified lesion, chronic total occlusion, or bifurcated target lesion. The primary endpoint was major adverse cardiac events (MACE) including all-cause death, recurrent myocardial infarction, and total coronary revascularization (target lesion revascularization, target vessel revascularization [TVR], and non-TVR) during the 5-year follow-up. The secondary endpoint was total coronary revascularization. Results:. Among the 7712 patients included, 4882 (63.3%) underwent CPCI. Compared with non-CPCI patients, CPCI patients had higher 2- and 5-year incidences of MACE and total coronary revascularization. Following multivariable adjustment including stent type, CPCI was an independent predictor of MACE (adjusted hazard ratio [aHR]: 1.151; 95% confidence interval [CI]: 1.017–1.303, P = 0.026) and total coronary revascularization (aHR: 1.199; 95% CI: 1.037–1.388, P = 0.014) at 5 years. The results were consistent at the 2-year endpoints. In patients with CPCI, BP-DES use was associated with significantly higher MACE rates at 5 years (aHR: 1.256; 95% CI: 1.078–1.462, P = 0.003) and total coronary revascularization (aHR: 1.257; 95% CI: 1.052–1.502, P = 0.012) compared with that of DP-DES, but there was a similar risk at 2 years. However, BP-DES had comparable safety and efficacy profiles including MACE and total coronary revascularization compared with DP-DES in patients with non-CPCI at 2 and 5 years. Conclusions:. Patients underwent CPCI remained at a higher risk of mid- to long-term adverse events regardless of the stent type. The effect of BP-DES compared with DP-DES on outcomes was similar in CPCI and non-CPCI patients at 2 years but had inconsistent effects at the 5-year clinical endpoints. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 0366-6999 2542-5641 00000000 |
| Relation: | http://journals.lww.com/10.1097/CM9.0000000000002450; https://doaj.org/toc/0366-6999; https://doaj.org/toc/2542-5641 |
| DOI: | 10.1097/CM9.0000000000002450 |
| Access URL: | https://doaj.org/article/e6f3614397884b7da9a1e78a1086d8fe |
| Accession Number: | edsdoj.6f3614397884b7da9a1e78a1086d8fe |
| Database: | Directory of Open Access Journals |
| ISSN: | 03666999 25425641 00000000 |
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| DOI: | 10.1097/CM9.0000000000002450 |
| Published in: | Chinese Medical Journal |
| Language: | English |