Incidence and Characteristics of Late Catch-Up Phenomenon Between Sirolimus-Eluting Stent and Everolimus-Eluting Stent: A Propensity Matched Study

J Interv Cardiol. 2015 Dec;28(6):551-62. doi: 10.1111/joic.12247. Epub 2015 Oct 21.

Abstract

Objectives: 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.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Coronary Artery Disease / therapy*
  • Coronary Restenosis / diagnosis
  • Coronary Restenosis / epidemiology*
  • Coronary Restenosis / therapy
  • Drug-Eluting Stents*
  • Everolimus / therapeutic use*
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Incidence
  • Male
  • Middle Aged
  • Propensity Score
  • Sirolimus / therapeutic use*
  • Treatment Outcome

Substances

  • Immunosuppressive Agents
  • Everolimus
  • Sirolimus