Comparison of Clinical Outcomes Between One- and Multi-Stent With 2nd Drug-Eluting Stents Patients up to 10-Year Follow-Up Results

초록

Background There are very limited long-term clinical outcome data comparing single- versus multi- (3 or more stents) stenting with second generation drug-eluting stents (DES). The authors sought to compare the efficacy of one- and multi-stent with DES patients who underwent successful percutaneous coronary intervention (PCI) during 10-year clinical follow-up periods. Methods A total of 1,137 consecutive patients who underwent PCI with one-(n=933) or multi- (3 or more stents, n=204) with second generation DES (zotarolimus [endeavor, endeavor resolute]- or everolimus-eluting stent [promus element, xience]) were enrolled. After propensity score matching (PSM), two PSM groups (198 pairs) were generated. The study endpoints were individual and composite clinical outcomes up to 10-year. Results During the 10-year follow-up period, the one-stent group had significant lower incidences of revascularization, (hazard ratio [HR]; 1.96, 95% confidence interval [CI]: 1.15-3.34, p=0.014), target lesion revascularization (TLR, HR; 4.24, 95% CI; 1.55-11.56, p=0.005), target vessel revascularization (TVR, HR; 2.39, 95% CI; 1.22-4.66, p=0.011), major adverse cardiac events (MACE, HR; 1.70, 95% CI: 1.10-2.63, p=0.016), TLR MACE (HR; 2.32, 95% CI; 1.15-4.64, p=0.018) than two stent group. However, the cumulative incidence of total death, cardiac death, myocardial infarction (MI), non-target vessel revascularization (NTVR), and stroke were similar between the two groups (table). Conclusion In our single-center, all-comer registry, the one-stent group showed a lower incidence of lesion-based clinical events including TLR, TVR, TLR-MACE and MACE, as compared with those of multi-stent group in patients during 10-year follow-up periods.