Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Cardiovascular Intervention
Comparison of the First- and Second-Generation Limus-Eluting Stents for Bifurcation Lesions From a Korean Multicenter Registry
– Different Efficacy in Left Main Bifurcation or 2-Stent Technique –
Youngjin ChoBon-Kwon KooYoung Bin SongJoo-Yong HahnSeung-Hyuk ChoiHyeon-Cheol GwonSeung Woon RhaCheol Woong YuJong-Seon ParkJang-Ho BaeJae-Hwan LeeMyung-Ho JeongJung Han YoonYangsoo JangHyo-Soo Kim
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Supplementary material

2015 Volume 79 Issue 3 Pages 544-552

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Abstract

Background:There are limited data on the relative efficacy of 1st- vs. 2nd-generation limus-eluting stents in bifurcation lesions.Methods and Results:Our analysis of a Korean multicenter registry for bifurcated coronary lesions enrolled 1,762 patients treated with 2nd-generation everolimus-eluting stent (EES, n=348) or 1st-generation sirolimus-eluting stents (SES, n=1,414). In the overall population, EES was comparable to SES regarding major adverse cardiac events (MACE: composite of cardiac death, nonfatal myocardial infarction, and target vessel revascularization (TVR)), cardiac death, and TVR rates within a 2-year follow-up. In 1:3 propensity score-matched populations, EES showed a significantly lower MACE rate compared with SES (HR [95% CI], 0.53 [0.29–0.97]; P=0.039), mainly through a reduction in repeat revascularization (HR [95% CI], 0.47 [0.24–0.92]; P=0.027). EES was superior to SES in reducing TVR in patients with left main (LM) lesions (HR [95% CI], 0.21 [0.06–0.67]; P=0.008) or in patients treated with 2-stent technique PCI (HR [95% CI], 0.28 [0.09–0.91]; P=0.035). There was no difference in clinical outcomes between 2 stents in a non-LM bifurcation lesion or in patients treated with a 1-stent technique.Conclusions:At 2-year follow-up, 1st- and 2nd-generation limus-eluting stents showed comparable clinical outcomes in general bifurcation lesions. EES was superior to SES after matching by propensity score, especially in patients with LM bifurcation or in those treated by a 2-stent technique. (Circ J 2015; 79: 544–552)

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© 2015 THE JAPANESE CIRCULATION SOCIETY
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