title: Two-year clinical outcomes of patients with overlapping second-generation drug-eluting stents for treatment of long coronary artery lesions: comparison of everolimus-eluting stents with resolute zotarolimus-eluting stents.
abstract: OBJECTIVE
  The aim of this study was to compare the 2-year clinical outcomes of overlapping second-generation everolimus-eluting stents (EES) with those of overlapping resolute zotarolimus-eluting stents (R-ZES) in the treatment of long coronary artery lesions.
  
  
  METHODS
  This retrospective analysis included 256 patients treated with overlapping EES (n=121) and R-ZES (n=135) for long coronary artery lesions (total stent length per lesion ≥34 mm). Study endpoints included major adverse cardiac events (MACE) defined as the composite of cardiac death, myocardial infarction, and target-vessel revascularization (TVR), as well as target-lesion revascularization and definite stent thrombosis separately at 2 years.
  
  
  RESULTS
  In the two groups, the mean age was older and the average number of disease vessel was higher in the R-ZES group. The mean lesion length and total stent length per lesion were longer in the R-ZES group. EES were more frequently implanted in the left anterior descending coronary artery. No significant differences in the estimated MACE (5.8% for EES vs. 8.1% for R-ZES; P=0.548) or TVR (3.4% for EES vs. 4.0% for R-ZES; P=0.806) rates were noted between the two groups at 2-year follow-up. The incidence of definite stent thrombosis was low and similar in both groups (0.83% for EES vs. 0% for R-ZES; P=0.473). No significant differences were noted with respect to MACE or TVR between the two groups following propensity score matching.
  
  
  CONCLUSIONS
  Stent overlap with second-generation EES or R-ZES was associated with low rates of MACE, TVR, and stent thrombosis at 2-year follow-up. Our results suggest that the use of overlapping EES or R-ZES in long coronary lesions is associated with good long-term clinical outcomes. These results need to be validated with randomized controlled trials.
authors.affiliation: aDepartment of Cardiology, Beijing Chao-Yang Hospital, Capital Medical University bDepartment of Cardiology, Beijing Corps Hospital, Chinese People's Armed Police Forces, Beijing, People's Republic of China.
authors.forename: Xiao-tao
authors.initials: XT
authors.lastname: Li
authors.forename: Hao
authors.initials: H
authors.lastname: Sun
authors.forename: Da-peng
authors.initials: DP
authors.lastname: Zhang
authors.forename: Li
authors.initials: L
authors.lastname: Xu
authors.forename: Zhu-hua
authors.initials: ZH
authors.lastname: Ni
authors.forename: Kun
authors.initials: K
authors.lastname: Xia
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.forename: Yong-hui
authors.initials: YH
authors.lastname: Chi
authors.forename: Ji-fang
authors.initials: JF
authors.lastname: He
authors.forename: Wei-ming
authors.initials: WM
authors.lastname: Li
authors.forename: Hong-shi
authors.initials: HS
authors.lastname: Wang
authors.forename: Le-feng
authors.initials: LF
authors.lastname: Wang
authors.forename: Xin-chun
authors.initials: XC
authors.lastname: Yang
mesh_terms: D000368:Aged; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D003328:Coronary Thrombosis / Q000209:etiology / Q000401:mortality; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D057216:Propensity Score; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D000068338:Everolimus; C489443:zotarolimus; D020123:Sirolimus