Propensity-Score Matched Comparison of Midterm Angiographic Outcomes of Sirolimus- Versus Everolimus- and Biolimus-Eluting Stents for De Novo Coronary Stenosis

• Published in: International Heart Journal Vol. 58; no. 3; pp. 320 - 327
• Main Authors: Suzuki, Kenichiro, Ishikawa, Tetsuya, Mutoh, Makoto, Sakamoto, Hiroshi, Mori, Chikara, Ogawa, Takayuki, Hashimoto, Koichi, Kubota, Takeyuki, Komukai, Kimiaki, Yoshimura, Michihiro, on Behalf of A Multicenter Registry in The Jikei University
• Format: Journal Article
• Language: English
• Published: Japan International Heart Journal Association 2017; Japan Science and Technology Agency
• Subjects: Aged; Angioplasty; Binary restenosis; Clinical trials; Coronary Angiography - methods; Coronary Stenosis - diagnosis; Coronary Stenosis - surgery; Coronary Vessels - diagnostic imaging; Coronary Vessels - surgery; Drug-Eluting Stents; Everolimus - pharmacology; Female; Follow-up result; Follow-Up Studies; Humans; Immunosuppressive Agents - pharmacology; Implants; Late luminal loss; Male; Percutaneous Coronary Intervention - methods; Propensity Score; Rapamycin; Retrospective Studies; Sirolimus - pharmacology; Stenosis; Stents; Target lesion revascularization; Time Factors; Treatment Outcome; Binary restenosis; Late luminal loss; Target lesion revascularization; Angioplasty; Follow-up result
• ISSN: 1349-2365; 1349-3299
• DOI: 10.1536/ihj.16-360

We conducted propensity-score matched comparisons of midterm angiographic outcomes of sirolimus (SES) versus either everolimus- (EES) or biolimus- (BES) eluting stents after placements for coronary stenosis in a daily practice environment since previous randomized trials did not demonstrate the superiority of EES and BES over SES in terms of midterm angiographic outcomes.The present study was a non-randomized, retrospective, and lesion-based study, recruiting angiographically followed-up lesions within 550 days after successful and elective SES (n = 1793), EES (n = 1303), or BES (n = 324) placement for de novo native coronary stenosis during the period from August 2004 to January 2014 at 6 institutes. The endpoint, as an angiographic surrogate marker of clinical efficacy, was the distribution of in-stent follow-up percent diameter stenosis (%DS) which comprised the percentages of 1) follow-up %DS < 20 and 2) follow-up %DS > 50. Propensityscore matched analyses were conducted to adjust 21 baselines.In 1215 baseline adjusted lesions, the endpoints in the EES group [1) 74.1%, and 2) 4.6%] were significantly different from those in the SES group [57.9%; P < 0.001, 7.2%; P = 0.006, respectively). In 307 baseline adjusted lesions, the endpoints in the BES group [1) 80.5%, 2) 2.0%] were significantly different from those in the SES group [59.3%; P < 0.001, 2) 8.1%; P = 0.001, respectively].The present study is the first to confirm the superiority of midterm angiographic outcomes after the placement of EES and BES over SES for de novo coronary stenosis in a clinical setting.