Safety, Effectiveness of Drug-Eluting Stents in Left Main CAD

Heart stent
Heart stent
There were no significant differences for the observed 3-year rates of target vessel failure for different types of drug-eluting stents in patients with left main coronary artery disease.

HealthDay News — There are few significant differences in target-vessel failure with different types of second-generation drug-eluting stents (DES) for obstructive left main coronary artery disease (LMCAD), according to a study published in the Journal of the American College of Cardiology.

Pil Hyung Lee, MD, from the University of Ulsan College of Medicine in Seoul, South Korea, and colleagues identified 2692 patients with significant LMCAD from 3 prospective registries who received second-generation DES: 1254 with cobalt-chromium everolimus-eluting stents (CoCr-EES), 232 with biodegradable polymer biolimus-eluting stents (BP-BES), 616 with platinum-chromium EES (PtCr-EES), and 590 with zotarolimus-eluting stents (Re-ZES).

The researchers found that there was no significant difference for the observed 3-year rates of target-vessel failure for the different types of DES (16.7% for the CoCr-EES, 13.2% for the BP-BES, 18.7% for the PtCr-EES, and 14.7% for the Re-ZES; P =.15). In between-group comparisons of the different DES, the adjusted hazard ratios for target-vessel failure were similar, except for the PtCr-EES vs the BP-BES (reference, hazard ratio, 1.6; 95% CI, 1.01-2.54; P =.046) in multiple treatment propensity score analysis.

“In this pooled analysis of 3 prospective registries involving unrestricted use of various second-generation DES for LMCAD, we found no significant between-group differences in 3-year risk of target-vessel failure, except for a higher risk of primary outcome with PtCr-EES compared to BP-BES,” the authors wrote.

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Hyung Lee P, Kwon O, Ahn JM, et al. Safety and effectiveness of second-generation drug-eluting stents in patients with left main coronary artery disease. J Am Coll Cardiol. 2018;71(8):832-841.