Key result
Zotarolimus-eluting stents linked to ~13% fewer uncovered struts versus sirolimus-eluting stents at 9 months.
Why the study?
The vascular response at 9 months after zotarolimus-eluting stent implantation and its comparison with sirolimus-eluting stents using optical coherence tomography was not well characterized.
Does zotarolimus-eluting stent implantation improve neointimal coverage and reduce malapposition compared to sirolimus-eluting stents at 9 months?
Cross-Sectional (n=68)
Single-blind
No
Does zotarolimus-eluting stent implantation improve neointimal coverage and reduce malapposition compared to sirolimus-eluting stents at 9 months?
Odds Ratio: 0.87 (95% CI 0.82–0.91)
Absolute Event Rate: 0.3% vs 12.3%
p-value: p=<0.001
Zotarolimus-eluting stents show almost complete neointimal coverage and rare malapposition at 9 months compared to sirolimus-eluting stents, suggesting a more favorable vascular healing profile.
OBJECTIVE: To evaluate the vascular response at 9 months after zotarolimus-eluting stent (ZES; Endeavor) implantation using optical coherence tomography (OCT). These findings were compared with those after implantation of a sirolimus-eluting stent (SES; Cypher Select). DESIGN: Cross-sectional observational study with prospective OCT registry. SETTING: Nine months after ZES or SES implantation. PATIENTS AND METHODS: A total of 68 patients (32 ZES and 36 SES) underwent OCT at 9 months after stent implantation. The neointima hyperplasia (NIH) thickness inside each strut and percentage of NIH area at every 1 mm cross section were measured. MAIN OUTCOME MEASUREMENT: The degree of neointimal coverage and the prevalence of malapposition at 9 months after ZES and SES implantation using OCT. RESULTS: The mean (SD) NIH thickness (251.2 (110.0) mum vs 85.5 (53.3) mum, p<0.001) and percentage of NIH area (27.9 (9.1)% vs 11.2 (7.1)%, p<0.001) were significantly greater in ZES than in SES. The prevalence of uncovered strut as well as malapposed strut was significantly lower in ZES than in SES (0.3% vs 12.3%, p<0.001 and 0.08% vs 2.6%, p<0.001). Thrombus was not observed in ZES (0.0% in ZES vs 27.8% in SES, p = 0.001). CONCLUSIONS: Neointimal coverage in ZES was almost complete and malapposition was very rare at 9-months' follow-up.
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Jang et al. (2009) conducted a cross-sectional in Coronary artery disease (n=68). Zotarolimus-eluting stent vs. Sirolimus-eluting stent was evaluated on Prevalence of uncovered stent struts (OR 0.87, 95% CI 0.82-0.91, p=<0.001). Zotarolimus-eluting stents were associated with a significantly lower prevalence of uncovered struts (0.3% vs 12.3%, OR 0.87) and malapposed struts compared to sirolimus-eluting stents at 9 months.
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