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Comparison of everolimus- and sirolimus-eluting stents in patients with long coronary artery lesions: a randomized LONG-DES-III (Percutaneous Treatment of LONG Native Coronary Lesions With Drug-Eluting Stent-III) Trial.

Authors
Park, DW; Kim, YH; Song, HG; Ahn, JM; Kim, WJ; Lee, JY; Kang, SJ; Lee, SW; Lee, CW; Park, SW; Yun, SC; Seung, KB; Yang, TH; Lee, SG; Lee, JH; Seong, IW; Cheong, SS; Lee, BK; Lee, NH; Lee, K; Kim, HS; Jeon, DS; Kim, MK; Nah, DY; Tahk, SJ; Park, SJ
Citation
JACC. Cardiovascular interventions, 4(10):1096-1103, 2011
Journal Title
JACC. Cardiovascular interventions
ISSN
1936-87981876-7605
Abstract
OBJECTIVES: This study compared everolimus-eluting stents (EES) and sirolimus-eluting stents (SES) for long coronary lesions.



BACKGROUND: Outcomes remain relatively unfavorable for stent-based coronary intervention of lesions with long diseased segments.



METHODS: This randomized, multicenter, prospective trial compared the use of long EES with SES in 450 patients with long (≥ 25 mm) native coronary lesions. The primary endpoint of the trial was in-segment late luminal loss at 9-month angiographic follow-up.



RESULTS: The EES and SES groups had similar baseline characteristics. Lesion length was 34.0 ± 15.4 mm in the EES group and 34.3 ± 13.5 mm in the SES group (p = 0.85). Nine-month angiographic follow-up was performed in 80% of the EES group and 81% of the SES group (p = 0.69). In-segment late loss as the primary study endpoint was significantly larger in the EES group than in the SES group (0.17 ± 0.41 mm vs. 0.09 ± 0.30 mm, p for noninferiority = 0.96, p for superiority = 0.04). The in-segment binary restenosis rate was also higher in the EES group than in the SES group (7.3% vs. 2.7%, p = 0.046). However, in-stent late loss (0.22 ± 0.43 mm vs. 0.18 ± 0.28 mm, p = 0.29) and in-stent binary restenosis rate (3.9% vs. 2.7%, p = 0.53) were similar among the 2 groups. The incidence of any clinical outcomes (death, myocardial infarction, stent thrombosis, target lesion revascularization, and composite outcomes) was not statistically different between the 2 groups.



CONCLUSIONS: For patients with long native coronary artery disease, EES implantation was associated with greater angiographic in-segment late loss and higher rates of in-segment restenosis compared with SES implantation. However, clinical outcomes were both excellent and not statistically different.
MeSH terms
Angioplasty, Balloon, CoronaryCoronary AngiographyCoronary Restenosis/*drug therapy/mortality/therapyCoronary Vessels/*pathology*Drug-Eluting StentsFemaleHumansImmunosuppressive Agents/*therapeutic useKaplan-Meier EstimateMaleMiddle AgedRecurrenceSirolimus/*analogs & derivatives/*therapeutic useStatistics as TopicTime Factors
DOI
10.1016/j.jcin.2011.05.024
PMID
22017935
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
AJOU Authors
탁, 승제
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