한빛사 논문
Abstract
Kyung Woo Park, MD, PhD1; Si-Hyuck Kang, MD, MSc1; Hyun-Jae Kang, MD, PhD1; Bon-Kwon Koo, MD, PhD1; Byoung-Eun Park, MD, PhD2; Kwang Soo Cha, MD, PhD3; Jay Young Rhew, MD, PhD4; Hui-Kyoung Jeon, MD, PhD5; Eun-Seok Shin, MD, PhD6; Ju Hyeon Oh, MD, PhD7; Myung-Ho Jeong, MD, PhD8; Sanghyun Kim, MD, PhD9; Kyung-Kuk Hwang, MD, PhD10; Jung-Han Yoon, MD, PhD11; Sung Yun Lee, MD, PhD12; Tae-Ho Park, MD, PhD13; Keon Woong Moon, MD, PhD14; Hyuck-Moon Kwon, MD, PhD1; Seung-Ho Hur, MD, PhD16; Jae-Kean Ryu, MD, PhD17; Bong-Ryul Lee, MD, PhD18; Yong Whi Park, MD, PhD19; In-Ho Chae, MD, PhD20; Hyo-Soo Kim, MD, PhD15
1 Seoul National University Hospital, Seoul, Korea
2 Dankook University Hospital, Cheonan, Korea
3 Busan National University Hospital, Busan, Korea
4 Presbyterian Medical Center, Jeonju, Korea
5 Uijeongbu St. Mary’s Hospital, Uijeongbu, Korea
6 Ulsan University Hospital, Ulsan, Korea
7 Samsung Changwon Hospital, Changwon, Korea
8 Chonnam National University Hospital, Gwangju, Korea
9 Boramae Medical Center, Seoul, Korea
10 Chungbuk National University Hospital, Cheongju, Korea
11 Wonju Christian Hospital, Wonju, Korea
12 Inje University Ilsan Paik Hospital, Goyang, Korea
13 Dong-A Medical Center, Busan, Korea
14 St. Vincent’s Hospital, Suwon, Korea
16 Keimyung University Dongsan Medical Center, Daegu, Korea
17 Daegu Catholic University Medical Center, Daegu, Korea
18 Daegu Fatima Hospital, Daegu, Korea
19 Gyeongsang National University Hospital, Jinju, Korea
20 Seoul National University Bundang Hospital, Seongnam, Korea
15 Gangnam Severance Hospital, Seoul, Korea
Dr. K. W. Park and Dr. S.-H. Kang contributed equally to this work.
Reprint requests and correspondence: Dr. Hyo-Soo Kim, Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, 101 Daehakro, Jongro Gu, Seoul 110-744, Republic of Korea.
Dr. In-Ho Chae, Cardiovascular Center, Seoul National University Bundang Hospital, 82 Gumi-Ro 173 Beon-Gil, Seongnam-Si, Gyueonggi-Do 463-707, Republic of Korea.
Abstract
Objectives To test whether the newly developed platinum chromium-based everolimus-eluting stent (PtCr-EES) is noninferior to the cobalt chromium-based zotarolimus-eluting stent (CoCr-ZES) in all-comers receiving percutaneous coronary intervention (PCI).
Background PtCr provides improved radial strength, conformability, and visibility compared to CoCr alloy, but PtCr-based stents have not been tested in a wide range of patients receiving PCI. Also, recent case series have raised the issue of longitudinal stent deformation (LSD) with newer DES.
Methods We randomly assigned 3,755 all-comers receiving PCI to PtCr-EES or CoCr-ZES. The primary outcome was target lesion failure (TLF) at 1 year post-PCI, defined as the composite of cardiac death, non-fatal target vessel-related myocardial infarction and ischemia-driven target lesion revascularization. Post-hoc angiographic analysis was performed to qualitatively and quantitatively analyze LSD.
Results At 1 year, TLF occurred in 2.9% and 2.9% of the population in the PtCr-EES and CoCr-ZES groups respectively (superiority p=0.98, noninferiority p=0.0247). There were no significant differences in the individual components of TLF, as well as the patient-oriented clinical outcome. Of 5,010 stents analyzed, LSD occurred in 0.2% and 0% in PtCr-EES and CoCr-ZES respectively (p=0.104). There was no significant difference in post-deployment stent length ratio between the two stents (p=0.352).
Conclusions At 1 year, PtCr-EES was non-inferior to CoCr-ZES in all-comers receiving PCI. Although, LSD was observed only in PtCr-EES, both the stent length ratio and the frequency of LSD were not significantly different between the two stent types, and was not associated with adverse clinical outcomes.
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