Late differences in outcomes of patients with stable angina and an isolated lesion in the proximal left anterior descending artery treated with new-generation drug-eluting stents ☆ Konstantinos Toutouzas a, ⁎, Nikolaos Anousakis-Vlachochristou a , Chrysoula Patsa a , Ioannis L. Matsoukis a,b , Maria Drakopoulou a , Eleftherios Tsiamis a , George Latsios a , Andreas Synetos a , Evmorfia Komatanou a , Anastasios Spanos c , Eleni Th. Petridou b , Dimitris Tousoulis a,1 a 1st Cardiology Department, Athens Medical School, Hippokration General Hospital, Athens, Greece b Department of Epidemiology and Medical Statistics, Athens Medical School, Athens, Greece c Cardiology Clinic, Naval Hospital of Athens, Greece abstract article info Article history: Received 20 December 2014 Accepted 25 January 2015 Available online 26 January 2015 Keywords: Proximal left anterior descending artery Chronic stable angina Drug-eluting stent Background: New-generation drug-eluting stents have demonstrated the mid-term efficacy and safety, but possible differences between stents may emerge in a long-term period. We compared long-term outcomes of patients with chronic stable angina and an isolated de-novo lesion in the proximal left anterior descending artery that underwent percutaneous coronary intervention with Endeavor-zotarolimus eluting stents (E-ZES) and everolimus eluting stents (EES). Methods: We prospectively enrolled 600 patients. Of these, 180 underwent E-ZES and 420 underwent EES im- plantation. Clinical follow-up was performed up to 7 years (median follow-up 61 months). The evaluated clinical outcomes were Target Lesion Failure (TLF), a composite of cardiac death, myocardial infarction and Target Lesion Revascularization (TLR), the Patient-Related Outcome (PRO) and stent thrombosis. Differences between groups evaluated with the Kaplan–Meier method and possible independent predictors with Cox proportional hazard re- gression. Results: At 5 years, the cumulative probability for outcomes was: TLF: 13.8% versus 7.5%, p = 0.025, cardiac death: 3.1% versus 2.5%, p = 0.937, myocardial infarction: 1.2% versus 1.8%, p = 0.829, TLR: 10% versus 3.3%, p = 0.003, PRO: 19.6% versus 13.8%, p = 0.528, ST: 2.5% versus 2.7%, p = 0.965, for E-ZES and EES respectively. Differences between stents increased after 30 months. In multivariate analysis predictors of TLF adjusted for stent type were Diabetes mellitus and estimated Glomerular Filtration Rate (eGFR). Conclusion: Both stents provided a favorable safety profile, with EES demonstrating better effectiveness. There was a late emergence in difference of endpoints after 30 months. Diabetes mellitus and eGFR predicted TLF. © 2015 Published by Elsevier Ireland Ltd. 1. Introduction The proximal segment of left anterior descending coronary artery (pLAD) has drawn special attention in percutaneous coronary interven- tions (PCI), due to its great importance for blood supply to over 50% of the left ventricular myocardium. The ongoing improvement in stent material and design has increased their safety and efficacy compared to first generation drug-eluting or bare-metal stents [1,2]. Among them, zotarolimus-eluting and Everolimus-eluting stents are being used in large numbers in interventional practice. Although, several studies that compare these two types of stents exist, there are limited data regarding the long-term outcomes in patients with isolated pLAD stenoses. The aim of this study was to evaluate the safety and efficacy of Everolimus-eluting and zotarolimus-eluting stents in patients with stable angina and an isolated de-novo lesion in the pLAD artery. International Journal of Cardiology 183 (2015) 27–32 Abbreviations: pLAD, proximal segment of left anterior descending artery; CAD, coro- nary artery disease; PCI, percutaneous coronary intervention; CABG, coronary artery by- pass grafting; DES, drug-eluting stents; E-ZES, Endeavor zotarolimus-eluting stent; EES, everolimus-eluting stent; eGFR, estimated Glomerular Filtration Rate; MDRD, Modification of Diet in Renal Disease study equation; CKD-EPI, Chronic Kidney Disease Epidemiology Collaboration study equation; ACC/AHA, American Cardiology College/ American Heart Association; MI, myocardial infarction; ST, stent thrombosis; ARC, Academic Research Consortium; TLF, Target Lesion Failure; TLR, Target Lesion Revascularization; PRO, Patient-Related Outcome. ☆ There are no potential conflicts of interest or funding sources to disclose. ⁎ Corresponding author at: Cardiology, Hippokration General Hospital, 114 Vas. Sofias ave, Athens, Greece. E-mail address: ktoutouz@gmail.com (K. Toutouzas). 1 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation. http://dx.doi.org/10.1016/j.ijcard.2015.01.044 0167-5273/© 2015 Published by Elsevier Ireland Ltd. Contents lists available at ScienceDirect International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard