Key result
Real-world ZES use is associated with low adverse events, including ~5% mortality.
Why the study?
Zotarolimus-eluting stents have been shown to be safe and effective in randomized trials, but clinical outcomes in real-world practice needed reporting.
Cohort (n=208)
Zotarolimus-eluting stents demonstrate a low incidence of adverse cardiac events and stent thrombosis in a real-world clinical cohort at 1.5 years follow-up.
Supports safety in unselected patients; hypothesis-generating and warrants randomized trials before practice change.
AIMS: Zotarolimus-eluting stents (ZESs) have been shown to be safe and effective in randomised trials. We sought to report the clinical outcomes after implantation of ZES in real-world clinical practice. METHODS AND RESULTS: ZES have been approved for clinical use in Singapore since April 2005. Until December 31, 2007, a total of 219 patients had undergone implantation of ZES. After excluding 11 foreign patients with whom contact was lost, 208 patients (246 lesions, 305 stents) formed the study cohort. A high-proportion of diabetic patients (n=90, 43.3%) was included. Recommended dual antiplatelet therapy was at least 3 months (n=147) for patients treated before or 12 months (n=61) after January 2007. As of January 2008, the median follow-up duration was 19 months (range: 1 to 33 months). There were 10 (4.8%) deaths, including 7 (3.4%) cardiac deaths. Myocardial infarction occurred in 11 (5.3%) patients. The numbers of patients requiring target vessel revascularisation and target lesion revascularisation were 10 (4.8%) and 5 (2.4%) respectively. Using the ARC definition, there were two cases of definite stent thrombosis on days 7 and 17, and one case of probable stent thrombosis on day 15. CONCLUSIONS: In this real-world clinical experience, ZES was associated with a low incidence of adverse cardiac events at a medium follow-up of one and half years.
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Lee et al. (2008) conducted a cohort in Coronary artery disease requiring stenting (n=208). Zotarolimus-eluting stents was evaluated on Adverse cardiac events. In a real-world clinical cohort, Zotarolimus-eluting stents were associated with low rates of adverse events at a median 19 months, including 4.8% death and 5.3% myocardial infarction.
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