Comparison of the First-and Second-Generation Limus-Eluting Stents for Bifurcation Lesions From a Korean Multicenter Registry - Different Efficacy in Left Main Bifurcation or 2-Stent Technique -

Title
Comparison of the First-and Second-Generation Limus-Eluting Stents for Bifurcation Lesions From a Korean Multicenter Registry - Different Efficacy in Left Main Bifurcation or 2-Stent Technique -
Author(s)
박종선조영진[조영진]구본권[구본권]송영빈[송영빈]한주영[한주영]최승혁[최승혁]권현철[권현철]라승운[라승운]유철웅[유철웅]배장호[배장호]이재환[이재환]정명호[정명호]윤정한[윤정한]장양수[장양수]김효수[김효수]
Keywords
CORONARY-ARTERY-DISEASE; RANDOMIZED-TRIAL; PROPENSITY SCORE; INTERVENTION; IMPLANTATION; RESTENOSIS; STRATEGY; OUTCOMES; BIAS
Issue Date
201503
Publisher
JAPANESE CIRCULATION SOC
Citation
CIRCULATION JOURNAL, v.79, no.3, pp.544 - +
Abstract
Background: There are limited data on the relative efficacy of 1st-vs. 2nd-generation limus-eluting stents in bifurcation lesions. Methods and Results: Our analysis of a Korean multicenter registry for bifurcated coronary lesions enrolled 1,762 patients treated with 2nd-generation everolimus-eluting stent (EES, n=348) or 1st-generation sirolimus-eluting stents (SES, n=1,414). In the overall population, EES was comparable to SES regarding major adverse cardiac events (MACE: composite of cardiac death, nonfatal myocardial infarction, and target vessel revascularization (TVR)), cardiac death, and TVR rates within a 2-year follow-up. In 1: 3 propensity score-matched populations, EES showed a significantly lower MACE rate compared with SES (HR [95% CI], 0.53 [0.29-0.97]; P=0.039), mainly through a reduction in repeat revascularization (HR [95% CI], 0.47 [0.24-0.92]; P=0.027). EES was superior to SES in reducing TVR in patients with left main (LM) lesions (HR [95% CI], 0.21 [0.06-0.67]; P=0.008) or in patients treated with 2-stent technique PCI (HR [95% CI], 0.28 [0.09-0.91]; P=0.035). There was no difference in clinical outcomes between 2 stents in a non-LM bifurcation lesion or in patients treated with a 1-stent technique. Conclusions: At 2-year follow-up, 1st- and 2nd-generation limus-eluting stents showed comparable clinical outcomes in general bifurcation lesions. EES was superior to SES after matching by propensity score, especially in patients with LM bifurcation or in those treated by a 2-stent technique.
URI
http://hdl.handle.net/YU.REPOSITORY/33180http://dx.doi.org/10.1253/circj.CJ-14-0802
ISSN
1346-9843
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의과대학 > 내과학교실 > Articles
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