Zotarolimus-eluting versus sirolimus-eluting coronary stent implantation

The safety and efficacy of coronary stents, utilized for treatment of ischemic heart disease, have been evaluated extensively. In comparison with bare-metal stents, first-generation drug-eluting stents more than halved the need for target lesion revascularization, but long-term safety has been questioned, as the first-generation drug-eluting stents seem to be associated with a small, but increased, risk of (very) late stent thrombosis. The latter may be related to an inflammatory reaction caused by the polymer used for drug-release control. The second-generation zotarolimus-eluting stent, Endeavor™, was believed to represent a safer alternative. We present an overview of the currently available data comparing Endeavor with the first-generation sirolimus-eluting stent, Cypher™. We also present the limited results with the next-generation of zotarolimus-and sirolimus-eluting stents.