Key result
Diabetes linked to ~15-fold higher angiographic restenosis odds in patients receiving Endeavor zotarolimus-eluting stents.
Why the study?
The angiographic and intravascular ultrasound findings of the Endeavor zotarolimus-eluting stent in real-world clinical practice patients were not well characterized.
Cohort (n=100)
No
Odds Ratio: 15.27 (95% CI 2.45–95.04)
Absolute Event Rate: 15.5% vs 2.6%
p-value: p=0.003
In a real-world cohort, zotarolimus-eluting stents showed favorable 6-month angiographic and IVUS results with low 1-year MACE and no stent thrombosis, though diabetes strongly predicted restenosis.
Endeavor ZES yielded favorable real-world angiographic/IVUS results in complex lesions; supports hypothesis generation but should not yet alter practice.
AIMS: The aim of this study was to investigate the angiographic and intravascular ultrasound (IVUS) findings of the Endeavor zotarolimus-eluting stent (ZES) in patients from a "real-world" clinical practice. METHODS AND RESULTS: From January to March 2006, 100 patients undergoing routine or emergency percutaneous intervention were prospectively enrolled at one institution. Overall, 39% of the patients were diabetics and 80.8% of lesions were type B2/C. A total of 140 lesions were successfully treated with 174 ZES, and procedural success was 98%. Mean vessel diameter was 2.69 mm and mean lesion length was 16.0 mm; at 6-month angiographic follow-up (completed in 96%), in-stent late lumen loss was 0.66 mm, and in-segment restenosis was 8.2%. Angiographic restenosis was increased among diabetics (15.5 vs. 2.6%, p=0.009), and diabetes was the only significant predictor of angiographic restenosis (OR=15.27 [95%CI 2.45-95.04], p=0.003). By IVUS (performed in 88% at 6-month), % volume obstruction was 14.4+/-13.4%, and there was no late acquired incomplete stent apposition (ISA). At 1-year, overall MACE rate was 6%, including 5 TLRs (4% of patients), with no occurrence of stent thrombosis. CONCLUSIONS: In this prospective "real-world" experience, the ZES demonstrated favourable angiographic and IVUS results in complex patients, with overall in-stent late lumen loss of 0.66 mm, and absence of late acquired ISA. At 1-year, there were no safety concerns including absence of death and stent thrombosis.
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Feres et al. (2009) conducted a cohort in patients undergoing routine or emergency percutaneous intervention (n=100). Endeavor zotarolimus-eluting stent was evaluated on angiographic restenosis (diabetics vs. non-diabetics) (OR 15.27, 95% CI 2.45-95.04, p=0.003). In patients receiving the Endeavor zotarolimus-eluting stent, diabetes was a significant predictor of angiographic restenosis (15.5% vs 2.6%; OR 15.27; 95% CI 2.45-95.04; p=0.003).
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