Why the study?
Does the use of everolimus-eluting stents compared to zotarolimus-eluting stents reduce mortality, MI, or repeat revascularization in patients undergoing percutaneous coronary interventions?
Does the use of everolimus-eluting stents compared to zotarolimus-eluting stents reduce mortality, MI, or repeat revascularization in patients undergoing percutaneous coronary interventions?
In a propensity-matched cohort, everolimus-eluting stents were associated with lower rates of repeat revascularization at 2 years compared to zotarolimus-eluting stents, with no difference in death or MI.
EES was associated with fewer repeat revascularizations than ZES without mortality difference; hypothesis-generating and should not yet change stent selection.
OBJECTIVES: To compare 2-year outcomes (mortality, mortality/myocardial infarction (MI), target vessel PCI (TVPCI), and target lesion PCI (TLPCI)) for patients receiving EES and ZES. BACKGROUND: The utilization of drug-eluting coronary stents (DES) among patients undergoing percutaneous coronary interventions (PCI) has increased dramatically in the last decade. Everolimus-eluting stents (EES) and ENDEAVOR zotarolimus eluting stents (ZES) constitute the latest generation of approved DES in the United States, but little is known about their relative effectiveness. METHODS: New York patients undergoing EES and ZES revascularization without any other type of stent between 7/08 and 12/08 were propensity matched at the hospital level using multiple patient, operator, and hospital characteristics, and matched patients were followed through the end of 2010 to obtain comparative 2-year outcomes. RESULTS: A total of 3286 patients were propensity-matched. Patients receiving EES had a significantly lower TVPCI rate (9.0% vs. 11.9%, AHR = 1.31, 95% CI (1.04, 1.65)) and a significantly lower TLPCI rate (6.0% vs. 8.3%, AHR = 1.35, 95% CI (1.02, 1.79)). There was no significant difference between EES and ZES for mortality or MI/mortality. CONCLUSIONS: There were no significant differences in the hard endpoints of death or MI between patients who received EES versus those who received ZES (ENDEAVOR). Patients with EES experienced lower repeat revascularization rates than patients with ZES at 24 months.
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Hannan et al. (2012) studied this question.
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