Abstract 18996: Comparison of Clinical Outcomes After Stent Implantation for Left Main Trunk Disease Between First- and Second-generation Drug-eluting Stent Eras
Purpose: In Japan, zotarolimus-eluting stent (ZES) became available from May 2009 and everolimus-eluting stent (EES) from January 2010 in addition to the first-generation drug-eluting stents (DES). The aim of this study was to clarify the impact of second-generation drug-eluting stent (DES) on clinical outcomes in left main trunk disease (LMTD).
Methods: A total of 238 patients (174 men, 64 women, mean age 70.8±10.1 years) who had undergone DES implantation for LMTD were classified into two groups: group A (first-generation DES era, 168 patients, March 2003 to April 2009, median follow-up period 1489 days, interquartile range [IQR] 1165-1967) and group B (second-generation DES era, 70 patients, May 2009 to December 2010, median follow-up period 608 days, IQR 450-721), and long-term clinical outcomes were assessed. Patients who had undergone percutaneous coronary intervention in the past were excluded.
Results: In group A, SES was deployed in 142 patients and PES in 3. In group B, ZES was deployed in 35 patients and EES in 18. Bifurcation lesion was significantly higher in group B (A, 75.6% vs. B, 88.6%, p=0.038). Syntax score showed no significant difference between groups (26.6±9.6 vs. 27.2±11.4, p=0.70). Stent strategy, either single- or two-stent, showed no significant difference (two-stent strategy: 30.4% vs. 28.6%, p=0.92). The Kaplan-Meier method revealed that the event-free survival rate of target vessel failure, defined as a composite of cardiac death, myocardial infarction, and target vessel revascularization, was significantly higher in group B (p=0.029).
Conclusion: Our data indicate that the outcomes of DES implantation for LMTD are more preferable in the second-generation DES era than in the first-generation DES era.
- © 2012 by American Heart Association, Inc.