Related Experiment Video
Updated: Dec 20, 2025
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
One-year outcomes of patients undergoing complex percutaneous coronary intervention with three contemporary
Lorenzo Azzalini1, Usman Baber1, Gurpreet S Johal1
1The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Insights
Comparing three types of everolimus-eluting stents (EES) in complex percutaneous coronary intervention (PCI), this study found similar 1-year outcomes for major adverse cardiac events (MACE) and stent thrombosis. Stent material and polymer type did not significantly impact patient results in this large cohort.
Area of Science:
- Cardiology
- Interventional Cardiology
- Biomaterials Science
Background:
- Controversy exists regarding the comparative efficacy of bioresorbable-polymer drug-eluting stents (BP-DES) versus durable-polymer DES (DP-DES).
- Real-world data on contemporary everolimus-eluting stents (EES) with different polymer coatings and base metals are limited, especially in complex percutaneous coronary intervention (PCI) scenarios.
Purpose of the Study:
- To evaluate and compare the 1-year clinical outcomes of three distinct everolimus-eluting stents (EES) used in percutaneous coronary intervention (PCI).
- To specifically assess outcomes in patients undergoing complex PCI, examining differences between cobalt-chromium durable-polymer EES (CoCr-DP-EES), platinum-chromium durable-polymer EES (PtCr-DP-EES), and platinum-chromium bioresorbable-polymer EES (PtCr-BP-EES).
Main Methods:
- A retrospective analysis of 5,446 patients undergoing PCI between 2015 and 2017 at a high-volume institution.
- Patients received either CoCr-DP-EES (Xience), PtCr-DP-EES (Promus), or PtCr-BP-EES (Synergy).
- The primary endpoint was 1-year major adverse cardiac events (MACE), with secondary analysis of stent thrombosis (ST) in the overall and complex PCI populations, adjusted via multivariable analysis.
Main Results:
- No significant difference in 1-year MACE rates was observed across the three stent types (8.9% for CoCr-DP-EES, 8.9% for PtCr-DP-EES, 8.6% for PtCr-BP-EES; p=0.97).
- Definite/probable stent thrombosis (ST) rates were also comparable (0.6% vs. 0.4% vs. 0.3%; p=0.69).
- In the complex PCI subgroup (53.1% of patients), MACE and ST rates remained similar across stent types, and stent type was not an independent predictor of MACE.
Conclusions:
- Comparable 1-year rates of MACE and definite/probable ST were observed for CoCr-DP-EES, PtCr-DP-EES, and PtCr-BP-EES.
- These findings hold true even for patients undergoing complex PCI, suggesting similar safety and efficacy profiles.
- Further multicenter randomized trials are recommended to confirm these real-world observations.
Objectives:
We aimed to evaluate the 1-year outcomes of three everolimus-eluting stents (EES) for complex percutaneous coronary intervention (PCI).
Background:
It is controversial whether contemporary bioresorbable-polymer drug-eluting stents (BP-DES) are associated with better outcomes compared with durable-polymer DES (DP-DES).
Methods:
Patients undergoing PCI with cobalt-chromium (CoCr)-DP-EES (Xience), platinum-chromium (PtCr)-DP-EES (Promus), or PtCr-BP-EES (Synergy) at one high-volume institution between 2015 and 2017 were included. The primary endpoint was 1-year major adverse cardiac events (MACE), a composite of death, myocardial infarction, and target-vessel revascularization. Associations were also examined in patients undergoing complex PCI. Multivariable analysis was conducted to adjust for baseline differences across groups.
Results:
We included n = 5,446 patients (CoCr-DP-EES, n = 3,177; PtCr-DP-EES, n = 1,555; PtCr-BP-EES, n = 714). Patients treated with PtCr-BP-EES had higher comorbidity burden and procedural complexity. At 1 year, MACE rates were 8.9% for CoCr-DP-EES versus 8.9% for PtCr-DP-EES versus 8.6% for PtCr-BP-EES (p = .97). The incidence of definite/probable stent thrombosis (ST) was also similar (0.6 vs. 0.4 vs. 0.3%, p = .69). Complex PCI was performed in n = 2,894/5,446 (53.1%). At 1 year, MACE rates were 11.5 versus 10.7 versus 10.3%, respectively (p = .83). The incidence of definite/probable ST was also similar (0.9 vs. 0.3 vs. 0.3%, p = .22). On multivariable analysis, stent type was not an independent predictor of MACE either in the overall or in the complex PCI population.
Conclusions:
We observed comparable 1-year rates of MACE and definite/probable ST in patients undergoing PCI with CoCr-DP-EES, PtCr-DP-EES, and PtCr-BP-EES. Results were unchanged among patients undergoing complex PCI. Future multicenter randomized studies should confirm and extend our findings.
More Related Videos
06:39Novel Percutaneous Approach for Deployment of 3D Printed Coronary Stenosis Implants in Swine Models of Ischemic Heart Disease
Published on: February 18, 2020
05:41Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
Published on: December 16, 2022
Related Concept Videos
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:27Coronary Artery Disease V: Interprofessional Care
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:27Peripheral Artery Disease III: Interprofessional Care
01:30Acute Coronary Syndrome I: Introduction
01:26Atherosclerosis III: Management