title: Late differences in outcomes of patients with stable angina and an isolated lesion in the proximal left anterior descending artery treated with new-generation drug-eluting stents.
abstract: BACKGROUND
  New-generation drug-eluting stents have demonstrated the mid-term efficacy and safety, but possible differences between stents may emerge in a long-term period. We compared long-term outcomes of patients with chronic stable angina and an isolated de-novo lesion in the proximal left anterior descending artery that underwent percutaneous coronary intervention with Endeavor-zotarolimus eluting stents (E-ZES) and everolimus eluting stents (EES).
  
  
  METHODS
  We prospectively enrolled 600 patients. Of these, 180 underwent E-ZES and 420 underwent EES implantation. Clinical follow-up was performed up to 7 years (median follow-up 61 months). The evaluated clinical outcomes were Target Lesion Failure (TLF), a composite of cardiac death, myocardial infarction and Target Lesion Revascularization (TLR), the Patient-Related Outcome (PRO) and stent thrombosis. Differences between groups evaluated with the Kaplan-Meier method and possible independent predictors with Cox proportional hazard regression.
  
  
  RESULTS
  At 5 years, the cumulative probability for outcomes was: TLF: 13.8% versus 7.5%, p=0.025, cardiac death: 3.1% versus 2.5%, p=0.937, myocardial infarction: 1.2% versus 1.8%, p=0.829, TLR: 10% versus 3.3%, p=0.003, PRO: 19.6% versus 13.8%, p=0.528, ST: 2.5% versus 2.7%, p=0.965, for E-ZES and EES respectively. Differences between stents increased after 30 months. In multivariate analysis predictors of TLF adjusted for stent type were Diabetes mellitus and estimated Glomerular Filtration Rate (eGFR).
  
  
  CONCLUSIONS
  Both stents provided a favorable safety profile, with EES demonstrating better effectiveness. There was a late emergence in difference of endpoints after 30 months. Diabetes mellitus and eGFR predicted TLF.
authors: 1st Cardiology Department, Athens Medical School, Hippokration General Hospital, Athens, Greece. Electronic address: ktoutouz@gmail.com.
authors: Konstantinos
authors: K
authors: Toutouzas
authors: 1st Cardiology Department, Athens Medical School, Hippokration General Hospital, Athens, Greece.
authors: Nikolaos
authors: N
authors: Anousakis-Vlachochristou
authors: 1st Cardiology Department, Athens Medical School, Hippokration General Hospital, Athens, Greece.
authors: Chrysoula
authors: C
authors: Patsa
authors: 1st Cardiology Department, Athens Medical School, Hippokration General Hospital, Athens, Greece; Department of Epidemiology and Medical Statistics, Athens Medical School, Athens, Greece.
authors: Ioannis L
authors: IL
authors: Matsoukis
authors: 1st Cardiology Department, Athens Medical School, Hippokration General Hospital, Athens, Greece.
authors: Maria
authors: M
authors: Drakopoulou
authors: 1st Cardiology Department, Athens Medical School, Hippokration General Hospital, Athens, Greece.
authors: Eleftherios
authors: E
authors: Tsiamis
authors: 1st Cardiology Department, Athens Medical School, Hippokration General Hospital, Athens, Greece.
authors: George
authors: G
authors: Latsios
authors: 1st Cardiology Department, Athens Medical School, Hippokration General Hospital, Athens, Greece.
authors: Andreas
authors: A
authors: Synetos
authors: 1st Cardiology Department, Athens Medical School, Hippokration General Hospital, Athens, Greece.
authors: Evmorfia
authors: E
authors: Komatanou
authors: Cardiology Clinic, Naval Hospital of Athens, Greece.
authors: Anastasios
authors: A
authors: Spanos
authors: Department of Epidemiology and Medical Statistics, Athens Medical School, Athens, Greece.
authors: Eleni Th
authors: ET
authors: Petridou
authors: 1st Cardiology Department, Athens Medical School, Hippokration General Hospital, Athens, Greece.
authors: Dimitris
authors: D
authors: Tousoulis
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000175:diagnosis*; D003324:Coronary Artery Disease / Q000601:surgery*; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020123:Sirolimus / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus; C489443:zotarolimus; D020123:Sirolimus
keywords: Chronic stable angina; Drug-eluting stent; Proximal left anterior descending artery