Chinese Medical Journal

ORIGINAL ARTICLE
Year
: 2017  |  Volume : 130  |  Issue : 14  |  Page : 1654--1661

Comparison of Efficacy and Safety between First and Second Generation Drug-eluting Stents in Patients with Stable Coronary Artery Disease: A Single-center Retrospective Study


Ru Liu1, Fei Xiong2, Yuan Wen2, Yuan-Liang Ma1, Yi Yao1, Zhan Gao1, Bo Xu1, Yue-Jin Yang1, Shu-Bin Qiao1, Run-Lin Gao1, Jin-Qing Yuan1 
1 Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China
2 Department of Physiology, Colleges of Pharmacy and Medicine, University of Kentucky, Lexington, KY 40536, USA

Correspondence Address:
Jin-Qing Yuan
Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037
China

Background: Lots of trials demonstrate that second-generation drug-eluting stents (G2-DES), with their improved properties, offer significantly superior efficacy and safety profiles compared to first generation DES (G1-DES) for patients with coronary artery disease (CAD) receiving percutaneous coronary intervention (PCI). This study aimed to verify the advantage of G2-DES over G1-DES in Chinese patients with stable CAD (SCAD). Methods: For this retrospective observational analysis, 2709 SCAD patients with either G1-DES (n = 863) or G2-DES (n = 1846) were enrolled consecutively throughout 2013. Propensity score matching (PSM) was applied to control differing baseline factors. Two-year outcomes, including major adverse coronary events as well as individual events, including target vessel-related myocardial infarction, target lesion revascularization (TLR), target vessel revascularization, and cardiogenic death were evaluated. Results: The incidence of revascularization between G1- and G2-DES showed a trend of significant difference with a threshold P - value (8.6% vs. 6.7%, χ2 = 2.995, P = 0.084). G2-DES significantly improved TLR-free survival compared to G1-DES (96.6% vs. 97.9%, P = 0.049) and revascularization-free survival curve showed a trend of improvement of G2-DES (92.0% vs. 93.8%, P = 0.082). These differences diminished after PSM. Multivariate Cox proportional hazard regression analysis showed a trend for G1-associated increase in revascularization (hazard ratio: 1.28, 95% confidence interval: 0.95–1.72, P = 0.099) while no significance was found after PSM. Other endpoints showed no significant differences after multivariate adjustment regardless of PSM. Conclusions: G1-DES showed the same safety as G2-DES in this large Chinese cohort of real-world patients. However, G2-DES improved TLR-free survival of SCAD patients 2 years after PCI. The advantage was influenced by baseline clinical factors. G1-DES was associated with a trend of increase in revascularization risk and was not an independent predictor of worse medium-term prognosis compared with G2-DES.


How to cite this article:
Liu R, Xiong F, Wen Y, Ma YL, Yao Y, Gao Z, Xu B, Yang YJ, Qiao SB, Gao RL, Yuan JQ. Comparison of Efficacy and Safety between First and Second Generation Drug-eluting Stents in Patients with Stable Coronary Artery Disease: A Single-center Retrospective Study.Chin Med J 2017;130:1654-1661


How to cite this URL:
Liu R, Xiong F, Wen Y, Ma YL, Yao Y, Gao Z, Xu B, Yang YJ, Qiao SB, Gao RL, Yuan JQ. Comparison of Efficacy and Safety between First and Second Generation Drug-eluting Stents in Patients with Stable Coronary Artery Disease: A Single-center Retrospective Study. Chin Med J [serial online] 2017 [cited 2017 Nov 22 ];130:1654-1661
Available from: http://www.cmj.org/article.asp?issn=0366-6999;year=2017;volume=130;issue=14;spage=1654;epage=1661;aulast=Liu;type=0