TY  - BOOK
AU  - Badr, Salem
AU  - Chen, Fang
AU  - Kitabata, Hironori
AU  - Loh, Joshua P
AU  - Pendyala, Lakshmana K
AU  - Pichard, Augusto D
AU  - Satler, Lowell F
AU  - Suddath, William O
AU  - Torguson, Rebecca
AU  - Waksman, Ron
TI  - A propensity score matched analysis to determine if second-generation drug-eluting stents outperform first-generation drug-eluting stents in a complex patient population
SN  - 0167-5273
KW  - *Drug-Eluting Stents/st [Standards]
KW  - *Myocardial Infarction/su [Surgery]
KW  - *Population Surveillance/mt [Methods]
KW  - *Propensity Score
KW  - *Thrombosis/pc [Prevention & Control]
KW  - Aged
KW  - Female
KW  - Follow-Up Studies
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Myocardial Infarction/di [Diagnosis]
KW  - Myocardial Infarction/ep [Epidemiology]
KW  - Percutaneous Coronary Intervention/st [Standards]
KW  - Prospective Studies
KW  - Thrombosis/ep [Epidemiology]
KW  - Treatment Outcome
KW  - MedStar Heart & Vascular Institute
KW  - Comparative Study
KW  - Journal Article
N2  - BACKGROUND: Drug-eluting stents (DES) are routinely used in complex patients, but the impact of 1st- versus 2nd-generation DES on clinical outcomes has not been well described. This study aimed to assess the efficacy and safety of 2nd-generation (everolimus-eluting) DES compared to 1st-generation (sirolimus- and paclitaxel-eluting) DES in a selected, higher-risk population with complex clinical and angiographic features; CONCLUSION: In this propensity score matched patient population with complex features undergoing percutaneous coronary intervention, the use of 2nd-generation DES was associated with lower rates of stent thrombosis, and similar 1-year major adverse cardiac events compared to 1st-generation DES.  2013; METHODS: The study included 5693 consecutive patients with the presence of > 1 predefined complex clinical and angiographic characteristic treated with either generation DES. Using propensity score matching, the clinical outcomes of 1076 patients treated with 2nd-generation DES were compared with the outcomes of a matched population treated with 1st-generation DES over 1-year follow-up; RESULTS: After matching, baseline clinical and angiographic characteristics were similar between groups. At 1-year follow-up, the rate of major adverse cardiac events was 9.4% with 2nd-generation DES and 11.3% with 1st-generation DES (p=0.16). There were no significant differences in the rates of death (3.2 vs. 4.0%, p=0.30), myocardial infarction (1.6 vs. 1.3%, p=0.57), target vessel revascularization (5.9 vs. 7.3%, p=0.17) or target lesion revascularization (4.4 vs. 5.0%, p=0.50). Definite stent thrombosis was less frequent with 2nd-generation DES (0.1 vs. 0.8%, p=0.011), as was definite or probable stent thrombosis (0.7 vs. 1.6%, p=0.040)
UR  - http://dx.doi.org/10.1016/j.ijcard.2013.10.004
ER  -