ESC Professional Members, Association Members (Ivory & above) benefit from year-round access to all the resources from their respective Association, and to all content from previous years. Fellows of the ESC (FESC), and professionals in training or under 40 years old, who subscribed to a Young Combined Membership package benefit from access to all ESC 365 content from all events, all editions, all year long. Find out more about ESC Memberships here.
Five-year major clinical outcomes between first-versus second-generation drug-eluting stents in coronary chronic total occlusions: propensity score matched analysis
Topic : interventional cardiology and cardiovascular surgery
Sub-topic : Outcome
Session type : Poster Session
Authors : Y H Kim (Chuncheon City,KR), AY Her (Chuncheon City,KR), SW Rha (Seoul,KP), BG Choi (Seoul,KP), SY Choi (Seoul,KP), JK Byun (Seoul,KP), CU Choi (Seoul,KP), EJ Kim (Seoul,KP), CG Park (Seoul,KP), HS Seo (Seoul,KP), DJ Oh (Seoul,KP)
Background: There is limited long-term clinical outcome data comparing first- versus second-generation drug-eluting stents (DESs) in patients with coronary chronic total occlusion (CTO) who underwent successful percutaneous coronary intervention (PCI).
Purpose: We investigated the 5-year major clinical outcomes of first- versus second-generation DESs in coronary CTO lesions.
Methods: A total of 822 consecutive patients who underwent PCI with DESs for CTO lesions were enrolled. Finally, 326 patients (first generation, n=153 vs second generation, n=173) were enrolled. To adjust baseline confounders, a propensity score matched (PSM) analysis was performed and 2 propensity-matched groups (128 pairs, n=256, C-statistic = 0.643) were generated. Cumulative major adverse cardiac events (MACEs) up to 5 years were compared between the two groups.
Results: During the 5-year follow-up, the cumulative incidences of total MACEs (HR, 2.40; 95% CI, 1.27–4.53; p=0.007) and target lesion revascularization (TLR: HR, 2.67; 95% CI, 1.14–6,28; p=0.024), target vessel revascularization (TVR: HR, 2.75; 95% CI, 1.23–6.11; p=0.013) were higher in the first-generation DESs group compared with the second-generation group after PSM (Table and Figure).
Conclusion(s): During 5-year follow-up, first-generation DESs showed higher incidence of MACEs, TLR and TVR rates in CTO patients than second-generation DESs following successful PCI. However, the incidence of total death and myocardial infarction were similar between the two groups.
Table 1. Cumulative clinical outcomes up to 5-year between first-generation and second-generation DESs