Comparison of 3-Year Clinical Outcomes Between Resolute™ Zotarolimus- and Sirolimus-Eluting Stents for Long Coronary Artery Stenosis

초록

Objectives: Long-term clinical outcomes were evaluated in long coronary artery stenosis treated with different types of drug-eluting stents. Background: Long-term follow-up data to compare clinical outcomes between Resolute zotarolimus-eluting stent (R-ZES) versus sirolimus-eluting stent (SES) implantation for long coronary artery stenosis is insufficient. Methods: A total of 254 patients (307 lesions) treated with R-ZES and 265 patients (303 lesions) treated with SES for long coronary lesions (total stent length 30mm) were enrolled, and long-term (3 years) clinical outcomes were compared between the 2 groups. Efficacy (target lesion revascularization [TLR]) and safety (the composite occurrence of cardiovascular death, target lesion-related myocardial infarction, or target lesion-related definite stent thrombosis) were assessed. Results: The 2 groups had similar baseline characteristics except for the duration of dual antiplatelet therapy (23.4 +/- 11.2 months in R-ZES-treated patients vs. 27.4 +/- 13.9 months in SES-treated patients, P<0.001). Total stent length was similar in R-ZES-treated patients (45.0 +/- 19.0mm) and SES-treated patients (45.4 +/- 18.6mm) (P=0.464). The cumulative TLR rate was 4.6% in R-ZES-treated patients versus 4.6% in SES-treated patients (P=0.911). For safety parameters, R-ZES-treated patients showed a significantly lower rate of the composite occurrence of cardiovascular death, target lesion-related myocardial infarction, or target lesion-related definite stent thrombosis than SES-treated patients (0.4% vs. 2.4%, P=0.042). Particularly, the occurrence of target lesion-related definite stent thrombosis was significantly lower in R-ZES-treated patients than in SES-treated patients (0.0% vs. 2.0%, P=0.028). Conclusions: R-ZES stents showed superior long-term safety than SES for treating long coronary lesions, while maintaining a similar clinical efficacy.

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