Three-Year Clinical Outcome of Patients with Coronary Disease and Increased Event Risk Treated with Newer-Generation Drug-Eluting Stents: From the Randomized DUTCH PEERS Trial

Liefke C. van der Heijden, Marlies M. Kok, Marije M. Löwik, Peter W. Danse, Gillian A.J. Jessurun, Marc Hartmann, Martin G. Stoel, Gert K. van Houwelingen, Raymond W.M. Hautvast, Gerard C.M. Linssen, Carine J.M. Doggen, Clemens Von Birgelen

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)

Abstract

Objective: Limited data is available on the long-term outcome of patients with increased cardiovascular event risk, treated with newer-generation durable polymer drug-eluting stents (DES).

Methods: We therefore assessed 3-year follow-up data of high-risk versus low-to intermediate-risk patients of the randomized DUTCH PEERS trial (NCT01331707). In both risk groups we also compared patients treated with Resolute Integrity versus Promus Element DES. Patients were categorized as "high-risk" if they met ≥1 of the following criteria: (1) diabetes (17.9%); (2) previous myocardial infarction (21.9%); (3) previous coronary revascularization (25.8%); (4) chronic renal failure (3.5%); (5) left ventricular ejection fraction ≤30% (1.5%); and (6) age ≥75 years (17.3%).

Results: At the 3-year follow-up, the incidence of the composite endpoint target vessel failure (TVF) (13.2 vs. 7.5%; logrank p < 0.001) and 2 of its components-cardiac death (4.7 vs. 1.5%; logrank p < 0.001) and target vessel revascularization (7.3 vs. 4.7%; logrank p = 0.03)-was higher in high-risk (n = 957) versus low-to intermediate-risk patients (n = 854). Among high-risk patients, treatment with Resolute Integrity (n = 481) and Promus Element stents (n = 476) was similarly safe and efficacious (TVF: 13.3 vs. 13.1%; logrank p = 0.95; definite-or-probable stent thrombosis: 1.7 vs. 1.7%; logrank p = 1.00).

Conclusions: The newer-generation Resolute Integrity and Promus Element stents showed similar results in terms of safety and efficacy for treating high-risk patients, who had significantly higher event rates than patients with low-to-intermediate risk.

Original languageEnglish
Pages (from-to)207-217
Number of pages11
JournalCardiology
Volume137
Issue number4
DOIs
Publication statusPublished - 1 Jul 2017

Keywords

  • High-risk patients
  • Newer-generation drug-eluting stent
  • Percutaneous coronary intervention
  • Promus Element everolimus-eluting stent
  • Resolute Integrity zotarolimus-eluting stent

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