Clinical Impact of Lesion Complexity on 2-Year Outcomes After Zotarolimus-Eluting Stents Implantation

• Published in: JACC. Asia 2021-12, Vol.1 (3), p.332-341
• Main Authors: Park, Jung-Ho, Lee, Cheol Hyun, Cho, Yun-Kyeong, Yoon, Hyuck-Jun, Nam, Chang-Wook, Park, Jong Seon, Kim, Kee-Sik, Park, Hun Sik, Lee, Bong-Ryeol, Shin, Eun-Seok, Bae, Jang-Ho, Kim, Young Dae, Hur, Seung-Ho
• Format: Article
• Language: English
• Subjects: complex percutaneous coronary artery intervention; coronary artery disease; drug-eluting stents
• ISSN: 2772-3747; 2772-3747
• DOI: 10.1016/j.jacasi.2021.08.006

The clinical efficacy and safety of second-generation drug-eluting stents in complex percutaneous coronary interventions (PCIs) are not well established. The clinical influence of the lesion complexity after PCI with zotarolimus-eluting stents (ZES) was evaluated. From a prospective multicenter observational study, a total of 926 patients that underwent successful PCIs with ZES were included. Complex PCIs were defined as patients with ≥3 lesions treated, 3 vessels treated, severe calcified lesions, bifurcated lesions with 2 stents implanted, left main disease, chronic total occlusion lesions, and/or diffuse long (total stent length ≥60 mm) lesions and were compared to the noncomplex group. The primary outcome was incidence of target lesion failures at 2 years, defined as a composite of cardiac death, target lesion-myocardial infarctions, and target lesion revascularization. The patients were divided into complex PCI (n = 249) and noncomplex (n = 677) groups. In the complex PCI group, the 2-year risk of a target lesion failure was not significantly higher than in the noncomplex PCI group (4.8% vs 3.7%; adjusted hazard ratio: 1.373; 95% confidence interval: 0.689–2.738; P = 0.367). The same trend was observed for all composites of the clinical outcomes. Older age and advanced chronic kidney disease were independent predictors for the primary outcome. Up to 2 years after a ZES implantation, the clinical outcomes did not differ according to lesion complexity. [Display omitted]