Comparison of Efficacy and Safety between First and Second Generation Drug-eluting Stents in Patients with Stable Coronary Artery Disease: A Single-center Retrospective Study
摘要Background:Lots of trials demonstrate that second-generation drug-eluting stents (G2-DES),with their improved properties,offer significantly superior efficacy and safety profiles compared to first generation DES (Gl-DES) for patients with coronary artery disease (CAD) receiving percutaneous coronary intervention (PCI).This study aimed to verify the advantage of G2-DES over G1-DES in Chinese patients with stable CAD (SCAD).Methods:For this retrospective observational analysis,2709 SCAD patients with either G1-DES (n =863) or G2-DES (n =1846) were enrolled consecutively throughout 2013.Propensity score matching (PSM) was applied to control differing baseline factors.Two-year outcomes,including major adverse coronary events as well as individual events,including target vessel-related myocardial infarction,target lesion revascularization (TLR),target vessel revascularization,and cardiogenic death were evaluated.Results:The incidence of revascularization between G1-and G2-DES showed a trend of significant difference with a threshold P-value (8.6% vs.6.7%,x2 =2.995,P =0.084).G2-DES significantly improved TLR-free survival compared to G1-DES (96.6% vs.97.9%,P =0.049) and revascularization-free survival curve showed a trend of improvement of G2-DES (92.0% vs.93.8%,P =0.082).These difterences diminished after PSM.Multivariate Cox proportional hazard regression analysis showed a trend for G 1-associated increase in revascularization (hazard ratio:1.28,95% confidence interval:0.95-1.72,P =0.099) while no significance was found after PSM.Other endpoints showed no significant differences after multivariate adjustment regardless of PSM.Conclusions:G1-DES showed the same safety as G2-DES in this large Chinese cohort of real-world patients.However,G2-DES improved TLR-ffee survival of SCAD patients 2 years after PCI.The advantage was influenced by baseline clinical factors.GI-DES was associated with a trend of increase in revascularization risk and was not an independent predictor of worse medium-term prognosis compared with G2-DES.
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