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Background/Aims: Despite improved revascularization techniques, the clinical outcomes of patients with diffuse coronary artery lesions after percutaneous coronary intervention are unsatisfactory. However, few studies have compared the efficacy of first- and second-generation drug-eluting stents (DES) in patients with diffuse long coronary artery lesions. Methods: Between January 2006 and July 2012, 364 patients who were treated with DES for long coronary artery stenosis (> 30 mm) were enrolled in this study and assigned to either Group I (first-generation DES, 62.3 ± 10.4 years, 136 males, n = 183) or Group II (second-generation DES, 64.3 ± 10.7 years, 134 males, n = 181). The incidence of major adverse cardiac events (MACE) was compared between the two groups over 2 years of follow-up, and predictive factors associated with MACE were evaluated through a multivariate analysis. Results: Although several coronary angiographic characteristics were different between the two groups, most demographic and baseline clinical variables were the same. The cumulative incidence of MACE was significantly higher in Group I than in Group II (25.7 vs. 6.6%, p < 0.001), mainly due to reduced target lesion revascularization (21.9 vs. 2.2%, p < 0.001). According to the results of the multivariate analysis, the use of a paclitaxel-eluting stent (PES) (hazard ratio [HR], 5.168, 95% confidence interval [CI], 2.515-10.617, p < 0.001), decreased left ventricular function (≤ 45%, HR, 3.586, 95% CI, 1.839-6.990, p < 0.001), and diabetes mellitus (HR, 2.984, 95% CI, 1.605-5.548, p < 0.001) were independent contributors to MACE.

the korean journal of medicine

Comparison of Clinical Outcomes after Implantation of First- and Second-Generation Overlapping Drug-Eluting Stents to Treat Diffuse Long Coronary Lesions