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Differences in lesion characteristics and patient background associated with the medium-term clinical outcomes of bare-metal and first-, second- and third-generation drug-eluting stents

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Abstract

We investigated the lesion characteristics and patient background factors associated with the medium-term incidence of major adverse cardiac events (MACEs) for bare-metal stents (BMS) and 1st-, 2nd- and 3rd-generation drug-eluting stents (DES) using the PCI-Registry (FU-Registry). Between January 2003 and March 2016, 2967 cases/3508 lesions for which percutaneous coronary intervention was performed at Fukuoka University Hospital and related facilities were enrolled. Patients were divided into BMS and 1st-, 2nd- and 3rd-generation drug-eluting stent (DES) groups. The incidence of MACEs in the BMS group (26.2%) was significantly higher than those in the 1st, 2nd and 3rd DES groups (18.0%, 12.5%, and 11.0%, respectively). The incidence of MACEs in the BMS group was strongly associated with insulin use, hemodialysis, low high-density lipoprotein cholesterol, stent minimum lesion diameter, stent length, severe calcification and a small vessel diameter of less than 2.5 mm. Some of these factors showed no association with MACEs among the drug-elution groups, and only hemodialysis, arteriosclerosis obliterans and severe calcification showed a strong correlation in the 2nd DES group. In the 3rd DES group, none of the factors considered were associated with MACEs. In conclusion, in stent implantation, the number of factors associated with MACEs has gradually decreased as the stent generation increased.

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Authors and Affiliations

  1. Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan

    Masayuki Nakamura, Amane Ike, Yuta Kato, Makito Futami, Takashi Kuwano, Makoto Sugihara, Atsushi Iwata, Akira Kawamura, Yasunori Suematsu & Shin-ichiro Miura

  2. Department of Cardiology, Fukuoka University Nishijin Hospital, 15-7 Sohara, Sawara-Ku, Fukuoka, 814-8522, Japan

    Shin-ichiro Miura

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  1. Masayuki Nakamura
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  2. Amane Ike
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  3. Yuta Kato
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  4. Makito Futami
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  5. Takashi Kuwano
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Correspondence to Amane Ike or Shin-ichiro Miura.

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Nakamura, M., Ike, A., Kato, Y. et al. Differences in lesion characteristics and patient background associated with the medium-term clinical outcomes of bare-metal and first-, second- and third-generation drug-eluting stents. Heart Vessels 36, 211–222 (2021). https://doi.org/10.1007/s00380-020-01692-z

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