Acute and Long-Term Angiographic Outcomes of Side Branch Stenosis after Randomized Treatment of Zotarolimus-, Sirolimus-, and Paclitaxel-Eluting Stent for Coronary Artery Stenosis

作者：Lee Bong Ki; Kim Young Hak; Park Duk Woo; Yun Sung Cheol; Ahn Jung Min; Song Hae Geun; Lee Jong Young; Kim Won Jang; Kang Soo Jin; Lee Seung Whan; Lee Cheol Whan; Lee Jae Hwan; Seong In Whan; Park Seong Wook; Park Seung Jung^*

来源：Journal of Korean Medical Science, 2012, 27(12): 1499-1506.

DOI：10.3346/jkms.2012.27.12.1499

• Drug-Eluting Stents
• Bifurcation
• Percutaneous Coronary Intervention
• Zotarolimus
• Sirolimus
• Paclitaxel

This was designed to assess the outcomes of side branch (SB) stenosis after implantation of three drug-eluting stents (DES). From 2,645 patients in the ZEST (Comparison of the Efficacy and Safety of Zotarolimus-Eluting Stent with Sirolimus-Eluting and PacliTaxel-Eluting Stent for Coronary Lesions) Trial, 788 patients had 923 bifurcation lesions with SB %26gt;= 1.5 mm were included. SB was treated in 150 lesions, including 35 (3.8%) receiving SB stenting. Of untreated SB with baseline stenosis %26lt; 50%, the incidences of periprocedural SB compromise was similar in the zotarolimus (15.8%), sirolimus (17.2%), and paclitaxel (16.6%) stent groups (P = 0.92). At follow-up angiography, delayed SB compromise occurred in 13.9%, 3.2%, and 9.4% (P = 0.010) of these groups. When classified into four groups (%26lt; 50%, 50%-70%, 70%-99%, and 100%), 9.0% of untreated SB were worsened, whereas improvement and stationary were observed in 9.6% and 81.4%. In a multivariable logistic regression model, main branch (MB) stenosis at follow-up (%) was the only independent predictor of SB stenosis worsening (odds ratio, 1.03; 95% confidence interval, 1.01-1.04; P %26lt; 0.001). After MB stenting in bifurcation lesions, a minority of SB appears to worsen. DES with strong anti-restenotic efficacy may help maintain SB patency.

• 出版日期2012-12