PLoS ONE (Jan 2016)

First-Generation Versus Second-Generation Drug-Eluting Stents in Coronary Chronic Total Occlusions: Two-Year Results of a Multicenter Registry.

  • Jong-Hwa Ahn,
  • Jeong Hoon Yang,
  • Cheol Woong Yu,
  • Je Sang Kim,
  • Hyun Jong Lee,
  • Rak Kyeong Choi,
  • Tae Hoon Kim,
  • Ho Joon Jang,
  • Young Jin Choi,
  • Young Moo Roh,
  • Won-Heum Shim,
  • Young Bin Song,
  • Joo-Yong Hahn,
  • Jin-Ho Choi,
  • Sang Hoon Lee,
  • Hyeon-Cheol Gwon,
  • Seung-Hyuk Choi

DOI
https://doi.org/10.1371/journal.pone.0157549
Journal volume & issue
Vol. 11, no. 6
p. e0157549

Abstract

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BACKGROUND:Limited data are available regarding the long-term clinical outcomes of second-generation drug-eluting stents (DES) versus first-generation DES in patients with coronary chronic total occlusion (CTO) who undergo percutaneous coronary intervention (PCI). The aim of this study was to compare the clinical outcomes of second-generation DES with those of first-generation DES for the treatment of CTO. METHODS AND RESULTS:Between March 2003 and February 2012, 1,006 consecutive patients with CTO who underwent successful PCI using either first-generation DES (n = 557) or second-generation DES (n = 449) were enrolled in a multicenter, observational registry. Propensity-score matching was also performed. The primary outcome was cardiac death over a 2-year follow-up period. No significant differences were observed between the two groups regarding the incidence of cardiac death (first-generation DES versus second-generation DES; 2.5% vs 2.0%; hazard ratio [HR]: 0.86; 95% confidence interval [CI]: 0.37 to 1.98; p = 0.72) or major adverse cardiac events (MACE, 11.8% vs 11.4%; HR: 1.00; 95% CI: 0.67 to 1.50; p = 0.99). After propensity score matching, the incidences of cardiac death (HR: 0.86; 95% CI: 0.35 to 2.06; p = 0.86) and MACE (HR: 0.93; 95% CI: 0.63 to 1.37; p = 0.71) were still similar in both groups. Furthermore, no significant differences were observed between sirolimus-eluting, paclitaxel-eluting, zotarolimus-eluting, and everolimus-eluting stents regarding the incidence of cardiac death or MACE. CONCLUSION:This study shows that the efficacy of second-generation DES is comparable to that of first-generation DES for treatment of CTO over 2 years of follow-up.