ABSTRACT
BACKGROUND: Procedural and clinical outcomes in patients with very long (>30mm) coronary lesions who underwent stent-based percutaneous coronary interventions are still unfavorable. Therefore, we compared the relative efficacy and safety of resolute zotarolimus-eluting stents (R-ZES) and Xpedition everolimus-eluting stents (X-EES) for patients with de novo very long coronary lesions. METHODS: This comparative single-centre, retrospective study compared long R-ZES and X-EES in consecutive patients admitted with very long (≥30mm) native ACC/AHA type C coronary lesions in 2014. All patients were followed up clinically at 1, 3, 6 and 12months. In this study, only symptom-driven angiogram was advised. The study end point was to evaluate immediate procedural success and one-year rate of target lesion failure (TLF), which is a composite of cardiac death, target lesion myocardial infarction, or target lesion revascularization (TLR). RESULTS: Total number of patients enrolled in this study was 185 (R-ZES=107; X-EES=78). The baseline characteristics and post procedural success rate were similar between R-ZES and X-EES groups, including the post stenting lesion lengths (36.6±1.92mm vs 40.71±6.175mm, P=0.09). At 12-month follow-up, there were no significant between-group differences in the rate of adverse clinical events (death, myocardial infarction, stent thrombosis, target lesion revascularization, and composite outcomes). Procedural success was achieved in 94% in R-ZES group and 93% in X-EES group (P=0.24). The incidence of TLF was 5% in R-ZES and 4% in X-EES groups (HR-1.25; 95% CI-0.86-5.6; P=0.19). CONCLUSION: Patients with de novo long coronary artery disease, R-ZES implantation showed similar clinical outcome as compared with X-EES implantation.
Subject(s)
Cardiovascular Agents/administration & dosage , Coronary Stenosis/therapy , Drug-Eluting Stents , Everolimus/administration & dosage , Percutaneous Coronary Intervention/instrumentation , Sirolimus/analogs & derivatives , Aged , Cardiovascular Agents/adverse effects , Coronary Angiography , Coronary Stenosis/diagnostic imaging , Coronary Stenosis/mortality , Everolimus/adverse effects , Female , Humans , India , Kaplan-Meier Estimate , Male , Middle Aged , Myocardial Infarction/etiology , Percutaneous Coronary Intervention/adverse effects , Proportional Hazards Models , Prosthesis Design , Retrospective Studies , Risk Factors , Sirolimus/administration & dosage , Sirolimus/adverse effects , Time Factors , Treatment OutcomeABSTRACT
BACKGROUND: The safety and efficacy of everolimus eluting bioabsorbable vascular scaffold (BVS) in the management of "ST" segment elevation myocardial infarction (STEMI) are yet to be established. AIMS: To evaluate immediate and short term safety and efficacy of the everolimus-eluting ABSORB BVS compared with non BVS drug eluting stent (DES) in patients with STEMI. METHODS: From December 2013 to December 2014, 220 patients with STEMI were included in this study. Among them, 35 patients treated with BVS were compared with a control group composed of 180 patients who underwent non BVS DES implantation in the same time period. The incidence of major adverse cardiac events (MACE: stent thrombosis: death, non-fatal myocardial infarction, or target vessel/lesion revascularization) before discharge and up to six months was evaluated. RESULTS: 1 vessel disease was more frequent whereas, 2 and 3 vessel disease was less frequent in BVS group. Procedural characteristics were also similar between groups, except for the use of post dilation (p=0.04). Procedural success, in-hospital, and up to six-month MACE rates were similar between both groups. Definite or probable stent thrombosis did not occur (according to the ARC criteria) in BVS patients, though two patients during the index admission and another two patients in the first month after DES implantation had stent thrombosis. CONCLUSION: The use of the ABSORB BVS for STEMI is feasible and associated with good procedural safety, and angiographic success rate.
