ISSN 2996-8215
International Journal of Cardiology | Vol. 2, No. 11, November 2011 | pp. 81–88
DOI: 10.46882/2011/IJC/000032
Original Research Article
Safety and Efficacy of Second-Generation Everolimus-Eluting Stents versus First-Generation Paclitaxel-Eluting Stents in Complex Coronary Lesions
Ji-Hoon Kim¹, Min-Soo Park¹, Sung-Hoon Choi²
¹Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea
²Division of Interventional Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Abstract:
First-generation drug-eluting stents (DES) significantly reduced restenosis but raised concerns regarding late stent thrombosis, particularly in complex coronary anatomy. Second-generation DES utilize thinner struts and biocompatible polymers to enhance vascular healing. This randomized, single-blind trial evaluated the 2-year clinical outcomes of second-generation everolimus-eluting stents (EES) compared to first-generation paclitaxel-eluting stents (PES) in patients with complex coronary artery lesions. We randomized 340 patients with complex lesions (type B2 or C according to ACC/AHA criteria) to undergo PCI with either EES (n = 170) or PES (n = 170). The primary endpoint was target lesion failure (TLF) at 2 years, defined as a composite of cardiac death, target vessel myocardial infarction (MI), or ischemia-driven target lesion revascularization (TLR). At 2 years, TLF occurred in 6.5% of the EES group compared to 13.5% of the PES group (p = 0.03). This difference was primarily driven by a significant reduction in target lesion revascularization (2.9% vs. 8.2%, p < 0.05). Definite or probable stent thrombosis was significantly lower in the EES group than in the PES group (0.6% vs. 2.4%, p = 0.04). Multivariable logistic regression identified first-generation PES use as an independent predictor of 2-year TLF (odds ratio: 2.24, 95% CI: 1.12–4.48, p = 0.02). Second-generation everolimus-eluting stents demonstrate superior safety and efficacy profiles over first-generation paclitaxel-eluting stents in complex coronary lesions, characterized by lower rates of target lesion failure and stent thrombosis.
Keywords: Percutaneous coronary intervention, Drug-eluting stents, Everolimus, Paclitaxel, Complex coronary lesions, Stent thrombosis
Received: August 01, 2011; Revised: September 15, 2011; Accepted: October 10, 2011; Published: November 20, 2011
Citation: International Journal of Cardiology, 2011, Vol. 2, No. 11, pp. 81–88, DOI: 10.46882/2011/IJC/000032
International Journal of Cardiology | Vol. 2, No. 12, December 2011 | pp. 89–96
DOI: 10.46882/2011/IJC/000033
Original Research Article