title: Comparison of outcomes after percutaneous coronary intervention for chronic total occlusion using everolimus- versus sirolimus- versus paclitaxel-eluting stents (from the Korean National Registry of Chronic Total Occlusion Intervention).
abstract: For the treatment of chronic total occlusion (CTO), the efficacy and safety of the everolimus-eluting stent (EES) remain less well defined. Also, there are limited data for the predictors of outcome after CTO intervention. The purpose of this study was to compare clinical outcomes of the EES with the first-generation drug-eluting stent (DES) in CTO intervention and to investigate the predictors of clinical outcome. The Korean National Registry of CTO Intervention is a retrospective cohort of 26 centers from the past 5 years. The primary end point was major adverse cardiovascular events (MACE) defined as a composite of cardiac death, nonfatal myocardial infarction, and target lesion revascularization. Of the 1,754 all-comer patients, 1,509 patients (EES 311, sirolimus-eluting stent [SES] 642, paclitaxel-eluting stent 556) were finally analyzed after excluding 245 patients (mixed DESs in 46 and follow-up loss in 199). In the inverse probability weighting-adjusted population, the 1-year MACE rate of the EES was comparable with that of the SES (5.8% vs 3.4%, p = 0.796) and the paclitaxel-eluting stent (5.8% vs 6.9%, p = 0.740). Each component of MACE was also comparable among the 3 stents. Importantly, the independent predictors of MACE were diabetes mellitus, previous congestive heart failure, and left circumflex CTO. In conclusion, for the first time in the largest CTO cohort, the EES showed good 1-year clinical outcomes that were comparable with the SES. Independent predictors of MACE after CTO intervention were clinical factors (diabetes and congestive heart failure) and lesion location.
authors.affiliation: Cardiovascular Center, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: Min-Ho
authors.initials: MH
authors.lastname: Lee
authors.affiliation: Cardiovascular Center, Seoul National University Hospital, Seoul, Korea.
authors.forename: Joo M
authors.initials: JM
authors.lastname: Lee
authors.affiliation: Cardiovascular Center, Seoul National University Hospital, Seoul, Korea.
authors.forename: Si-Hyuck
authors.initials: SH
authors.lastname: Kang
authors.affiliation: Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Chang-Hwan
authors.initials: CH
authors.lastname: Yoon
authors.affiliation: Yonsei University Severance Hospital, Seoul, Korea.
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.affiliation: Sejong General Hospital, Bucheon, Korea.
authors.forename: Cheol W
authors.initials: CW
authors.lastname: Yu
authors.affiliation: Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Hun S
authors.initials: HS
authors.lastname: Park
authors.affiliation: Yonsei University Wonju Severance Hospital, Wonju, Korea.
authors.forename: Seung-Hwan
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Keimyung University Dongsan Medical Center, Daegu, Korea.
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Hur
authors.affiliation: Dong-A University Medical Center, Busan, Korea.
authors.forename: Moo H
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Guro Hospital, Korea University, Seoul, Korea.
authors.forename: Seung-Woon
authors.initials: SW
authors.lastname: Rha
authors.affiliation: Samsung Medical Center, Sung-Kyun-Kwan University, Seoul, Korea.
authors.forename: Hyeon-Cheol
authors.initials: HC
authors.lastname: Gwon
authors.affiliation: Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Chae
authors.affiliation: Cardiovascular Center, Seoul National University Hospital, Seoul, Korea. Electronic address: hyosoo@snu.ac.kr.
authors.forename: Hyo-Soo
authors.initials: HS
authors.lastname: Kim
mesh_terms: D000970:Antineoplastic Agents; D002908:Chronic Disease; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D054855:Drug-Eluting Stents; D004562:Electrocardiography; D000068338:Everolimus; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000494:pharmacology*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000494:pharmacology*; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D000068338:Everolimus; D017239:Paclitaxel; D020123:Sirolimus