Homogeneous, heterogeneous DES have similar clinical outcomes
MedWire News: Korean researchers have found that the long-term clinical outcomes of patients with overlapping heterogeneous drug-eluting stents (DES) are similar to those of patients with overlapping homogenous DES.
While the implantation of long or multiple overlapping homogeneous DES is associated with good clinical outcomes, the safety and efficacy of overlapping with a different DES type are unknown, write Dong-Bin Kim (The Catholic University of Korea, Seoul) and colleagues in the journal Heart.
The current study compared the occurrence of major adverse cardiac events (MACE), defined as cardiac death, myocardial infarction (MI), or target lesion revascularization (TLR), in 940 patients with overlapping homogeneous DES and 140 patients with overlapping heterogeneous DES.
The patients were treated at eight centers in Korea between January 2005 and June 2010. All patients had one-vessel disease treated with two overlapping DES in one lesion.
The findings revealed that over a median follow-up period of 26 months, MACE rates between the homogenous and heterogenous DES groups were not significantly different (9.9% vs 11.4%, respectively).
Furthermore, the individual components of the primary endpoint did not differ significantly between the homogenous and heterogeneous DES groups, at respective rates of 2.7% versus 3.6% for cardiac death (p=0.578), 1.5% versus 1.4% for MI (p=1.000), and 5.7% vs 6.4% for TLR (p=0.747).
Further analysis showed that MACE occurred more frequently in patients implanted with overlapping first-generation homogeneous DES, at 11.8%, than in those with second-generation homogeneous DES, at 7.0% (p=0.021).
In addition, the rate of MACE-free survival was higher in patients implanted with sirolimus-eluting stents than in those with paclitaxel-eluting stents (p=0.014).
"A larger clinical trial, especially with a greater number of overlapping heterogeneous DES, is necessary to confirm these findings," conclude the authors.
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By Piriya Mahendra