Incidence and Characteristics of Late Catch-Up Phenomenon Between Sirolimus-Eluting Stent and Everolimus-Eluting Stent: A Propensity Matched Study.
OBJECTIVE
We evaluated and compared the incidence and characteristics of late catch-up phenomenon (LCU) between everolimus-eluting stent (EES) and sirolimus-eluting stent (SES) implantations.


BACKGROUND
Late catch-up phenomenon after everolimus-eluting stent (EES) implantation has not yet been evaluated sufficiently.


METHODS
Between April 2007 and May 2011, 1,234 patients with coronary artery disease were treated with SES and 502 patients with EES. Following propensity score matching, we evaluated 495 SES-treated patients and 495 ESS-treated patients. The incidences of LCU (i.e., late target lesion revascularization [TLR] [1-3 years]) were compared.


RESULTS
The cumulative incidence of TLR at 3 years was 11.9% in the SES group and 6.1% in the EES group (P = 0.001). The incidence of late TLR was 7.5% in the SES group and 3.4% in the EES group (P = 0.004). Even though not statistically significant, intravascular ultrasound showed a higher tendency of stent fracture (SF) in late restenosis lesions in the SES group than in the EES group (37.0% vs 7.7%; P = 0.052). Moreover, the SF rate tended to increase in late restenosis compared with early restenosis (within 1 year) in the SES group compared with the EES group (SES: 37.0% vs 22.2%; P = 0.293, EES: 7.7% vs 10.0%; P = 0.846), although the increase was not significantly different.


CONCLUSIONS
EES was superior to SES in terms of LCU. SF may be associated with LCU after SES implantation.
Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Kanagawa, Japan.
Norihiro
N
Kobayashi
Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Kanagawa, Japan.
Yoshiaki
Y
Ito
Department of Cardiology, General Tokyo Hospital, Tokyo, Japan.
Masatsugu
M
Nakano
Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Kanagawa, Japan.
Motoharu
M
Araki
Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Kanagawa, Japan.
Keisuke
K
Hirano
Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Kanagawa, Japan.
Masahiro
M
Yamawaki
Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Kanagawa, Japan.
Hideyuki
H
Takimura
Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Kanagawa, Japan.
Yasunari
Y
Sakamoto
Department of Cardiology, General Tokyo Hospital, Tokyo, Japan.
Reiko
R
Tsukahara
Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Kanagawa, Japan.
Toshiya
T
Muramatsu
D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000628:therapy*; D023903:Coronary Restenosis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D020123:Sirolimus / Q000627:therapeutic use*; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D000068338:Everolimus; D020123:Sirolimus