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Park JH, Lee CH, Cho YK, Yoon HJ, Nam CW, Park JS, Kim KS, Park HS, Lee BR, Shin ES, Bae JH, Kim YD, Hur SH. Clinical Impact of Lesion Complexity on 2-Year Outcomes After Zotarolimus-Eluting Stents Implantation. JACC. ASIA 2021; 1:332-341. [PMID: 36341214 PMCID: PMC9627827 DOI: 10.1016/j.jacasi.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/17/2021] [Accepted: 08/17/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND The clinical efficacy and safety of second-generation drug-eluting stents in complex percutaneous coronary interventions (PCIs) are not well established. OBJECTIVES The clinical influence of the lesion complexity after PCI with zotarolimus-eluting stents (ZES) was evaluated. METHODS From a prospective multicenter observational study, a total of 926 patients that underwent successful PCIs with ZES were included. Complex PCIs were defined as patients with ≥3 lesions treated, 3 vessels treated, severe calcified lesions, bifurcated lesions with 2 stents implanted, left main disease, chronic total occlusion lesions, and/or diffuse long (total stent length ≥60 mm) lesions and were compared to the noncomplex group. The primary outcome was incidence of target lesion failures at 2 years, defined as a composite of cardiac death, target lesion-myocardial infarctions, and target lesion revascularization. RESULTS The patients were divided into complex PCI (n = 249) and noncomplex (n = 677) groups. In the complex PCI group, the 2-year risk of a target lesion failure was not significantly higher than in the noncomplex PCI group (4.8% vs 3.7%; adjusted hazard ratio: 1.373; 95% confidence interval: 0.689-2.738; P = 0.367). The same trend was observed for all composites of the clinical outcomes. Older age and advanced chronic kidney disease were independent predictors for the primary outcome. CONCLUSIONS Up to 2 years after a ZES implantation, the clinical outcomes did not differ according to lesion complexity.
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Key Words
- CKD, chronic kidney disease
- DES, drug-eluting stent(s)
- IVUS, intravascular ultrasound
- MACE, major adverse cardiac events
- MI, myocardial infarction
- OCT, optical coherence tomography
- PCI, percutaneous coronary intervention
- TLF, target lesion failure
- TLR, target lesion revascularization
- ZES, zotarolimus-eluting stent(s)
- complex percutaneous coronary artery intervention
- coronary artery disease
- drug-eluting stents
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Affiliation(s)
- Jung-Ho Park
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Cheol Hyun Lee
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Yun-Kyeong Cho
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Hyuck-Jun Yoon
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Chang-Wook Nam
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Jong Seon Park
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, South Korea
| | - Kee-Sik Kim
- Division of Cardiology, Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, South Korea
| | - Hun Sik Park
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, South Korea
| | - Bong-Ryeol Lee
- Division of Cardiology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, South Korea
| | - Eun-Seok Shin
- Division of Cardiology, Department of Internal Medicine, Ulsan University Hospital, Seoul, South Korea
| | - Jang-Ho Bae
- Division of Cardiology, Department of Internal Medicine, Konyang University Hospital, Nonsan, South Korea
| | - Young Dae Kim
- Division of Cardiology, Department of Internal Medicine, Dong-A University College of Medicine, Busan, South Korea
| | - Seung-Ho Hur
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea
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