Ten-year major clinical outcomes between first- and second-generation Drug-Eluting Stents in unstable angina patients underwent Percutaneous Coronary Intervention

Abstract Background There are very limited long-term clinical outcome data comparing first-generation (1G) versus second-generation (2G) drug-eluting stents (DES) in unstable angina (UA) patients. The authors sought to compare the efficacy and safety 2G-DES with 1G-DES in dyslipidemia patients who underwent percutaneous coronary intervention (PCI) during ten-year clinical follow-up periods. Methods Finally, a total of 878 eligible UA patients who underwent PCI with 1G-DES (paclitaxel-, sirolimus-eluting stent, n = 333) or 2G-DES (zotarolimus [endeavor, endeavor resolute]- or everolimus-eluting stent [promus element, xience], n = 545) were enrolled. The study endpoints were individual and composite clinical outcomes up to ten-year. Results After PSM, two propensity-matched (PSM) groups (216 pairs) were generated. During the ten-year follow-up period, the 2G-DES group had a lower incidence of target lesion revascularization (TLR; hazard ratio [HR], 0.43; 95% confidence interval [CI], 0.22 – 0.84; p = 0.013), target vessel revascularization (TVR; HR, 0.40; 95% CI, 0.23 – 0.71; p = 0.002), any revascularization (HR, 0.48; 95% CI, 0.31 – 0.75; p < 0.001), total major adverse cardiac events (MACE; HR, 0.54; 95% CI, 0.37 – 0.81; p = 0.003), TLR MACE (HR, 0.54; 95% CI, 0.30 – 0.97; p = 0.038), and MACCE (HR, 0.62; 95% CI, 0.42 – 0.90; p = 0.012, table). Conclusion In our single-center, all-comer registry, 2G-DES had better efficacy especially repeat revascularization compared with 1G-DES in UA patients during 10-year follow-up periods.