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Two-year clinical outcomes of patients with overlapping second-generation drug-eluting stents for treatment of long coronary artery lesions: comparison of everolimus-eluting stents with resolute zotarolimus-eluting stents

Li, Xiao-taoa,b; Sun, Haoa; Zhang, Da-penga; Xu, Lia; Ni, Zhu-huaa; Xia, Kuna; Liu, Yua; Chi, Yong-huia; He, Ji-fanga; Li, Wei-minga; Wang, Hong-shia; Wang, Le-fenga; Yang, Xin-chuna

doi: 10.1097/MCA.0000000000000098
Original Research

Objective: The aim of this study was to compare the 2-year clinical outcomes of overlapping second-generation everolimus-eluting stents (EES) with those of overlapping resolute zotarolimus-eluting stents (R-ZES) in the treatment of long coronary artery lesions.

Materials and methods: This retrospective analysis included 256 patients treated with overlapping EES (n=121) and R-ZES (n=135) for long coronary artery lesions (total stent length per lesion ≥34 mm). Study endpoints included major adverse cardiac events (MACE) defined as the composite of cardiac death, myocardial infarction, and target-vessel revascularization (TVR), as well as target-lesion revascularization and definite stent thrombosis separately at 2 years.

Results: In the two groups, the mean age was older and the average number of disease vessel was higher in the R-ZES group. The mean lesion length and total stent length per lesion were longer in the R-ZES group. EES were more frequently implanted in the left anterior descending coronary artery. No significant differences in the estimated MACE (5.8% for EES vs. 8.1% for R-ZES; P=0.548) or TVR (3.4% for EES vs. 4.0% for R-ZES; P=0.806) rates were noted between the two groups at 2-year follow-up. The incidence of definite stent thrombosis was low and similar in both groups (0.83% for EES vs. 0% for R-ZES; P=0.473). No significant differences were noted with respect to MACE or TVR between the two groups following propensity score matching.

Conclusion: Stent overlap with second-generation EES or R-ZES was associated with low rates of MACE, TVR, and stent thrombosis at 2-year follow-up. Our results suggest that the use of overlapping EES or R-ZES in long coronary lesions is associated with good long-term clinical outcomes. These results need to be validated with randomized controlled trials.

aDepartment of Cardiology, Beijing Chao-Yang Hospital, Capital Medical University

bDepartment of Cardiology, Beijing Corps Hospital, Chinese People’s Armed Police Forces, Beijing, People’s Republic of China

Correspondence to Xin-chun Yang, MD, Department of Cardiology, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongtinan Road, Chaoyang District, Beijing 100020, People’s Republic of China Tel/fax: +86 010 57201170; e-mail:

Received December 9, 2013

Received in revised form January 24, 2014

Accepted January 27, 2014

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins