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이달의 kcj Hot Article / 2019년 8월
Effectiveness and Safety of Zotarolimus-Eluting Stent (Resolute™ Integrity) in Patients with Diffuse Long Coronary Artery Disease

저자

Keun-Ho Park, MD,1 Youngkeun Ahn, MD, PhD,2 Young-Youp Koh, MD,1 Young-Jae Ki, MD,1 Sung Soo Kim, MD,1 Hyun Kuk Kim, MD,1 Dong-Hyun Choi, MD,1 Young Joon Hong, MD,2 Jin-Yong Hwang, MD,3 Do Hoi Kim, MD,4 Jay Young Rhew, MD,5 Jae Kean Ryu, MD,6 Jong-Seon Park, MD,7 Tae Ho Park, MD,8 Tae Hyun Yang, MD,9 Seok Kyu Oh, MD,10 Bong Ryeol Lee, MD,11 Seung-Uk Lee, MD,12 Sang Gon Lee, MD,13 Kook Jin Chun, MD,14 Jang-Hyun Cho, MD,15 Kwang Soo Cha, MD,16 Jei Keon Chae, MD,17 Seung-Ho Hur, MD,18 Sun Ho Hwang, MD,19 Hun-Sik Park, MD,20 and Doo-Il Kim, MD21

소속

1Division of Cardiology, Department of Internal Medicine, Chosun University Hospital, Gwangju, Korea. 2Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea. 3Division of Cardiology, Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, Korea. 4Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Hospital Gumi, Gumi, Korea. 5Division of Cardiology, Presbyterian Medical Center, Jeonju, Korea. 6Division of Cardiology, Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Korea. 7Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea. 8Division of Cardiology, Department of Internal Medicine, Dong-A University Hospital, Busan, Korea. 9Division of Cardiology, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea. 10Division of Cardiology, Department of Internal Medicine, Wonkwang University Hospital, Iksan, Korea. 11Division of Cardiology, Daegu Fatima Hospital, Daegu, Korea. 12Division of Cardiology, Kwangju Christian Hospital, Gwangju, Korea. 13Division of Cardiology, Department of Internal Medicine, Ulsan University Hospital, Ulsan, Korea. 14Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea. 15Division of Cardiology, St. Carollo Hospital, Suncheon, Korea. 16Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital, Busan, Korea. 17Division of Cardiology, Department of Internal Medicine, Chonbuk National University Hospital, Jeonju, Korea. 18Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, Korea. 19Division of Cardiology, Gwangju Veterans Hospital, Gwangju, Korea. 20Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea. 21Division of Cardiology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Korea.

Background and Objectives

Diffuse long coronary artery disease (DLCAD) still has unfavorable clinical outcomes after successful percutaneous coronary intervention (PCI). Therefore, we aimed to evaluate the effectiveness and safety of Resolute™ zotarolimus-eluting stent (R-ZES; Resolute™ Integrity) for patients with DLCAD.

Methods

From December 2011 to December 2014, 1,011 patients who underwent PCI using R-ZES for CAD with longer than 25 mm lesion were prospectively enrolled from 21 hospitals in Korea. We assessed the clinical outcome of major adverse cardiac events (MACE) defined as the composite of cardiac death, non-fatal myocardial infarction (MI), and clinically-driven target vessel revascularization at 12 months.

Results

Mean age was 63.8±10.8 years, 701 (69.3%) patients were male, 572 (87.0%) patients had hypertension, 339 (33.8%) patients had diabetes, 549 (54.3%) patients diagnosed with acute MI and 545 (53.9%) patients had multi-vessel disease (MVD). A total of 1,697 stents were implanted into a total of 1,472 lesions. The mean diameter was 3.07±0.38 mm and the length was 28.27±6.97 mm. Multiple overlapping stents were performed in 205 (13.8%) lesions. A 12-month clinical follow-up was available in 1,004 patients (99.3%). The incidences of MACE and definite stent thrombosis at 12-month were 3.0% and 0.3% respectively. On multivariate Cox-regression analysis, multiple overlapping stents implantation, previous congestive heart failure, MVD, and age ≥75 years were independent predictors of one-year MACE.

Conclusions

Our study shows that R-ZES has an excellent 1-year clinical outcome in Korean patients with DLCAD.


Keywords: Drug-eluting stents; Coronary artery disease; Treatment outcome

본문바로가기 : https://www.e-kcj.org/DOIx.php?id=10.4070/kcj.2019.0018

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