Key result
Resolute ZES linked to ~2 percentage points fewer 3-year safety events vs SES.
Cohort (n=519)
Absolute Event Rate: 0.4% vs 2.4%
p-value: p=0.042
R-ZES was associated with similar TLR but lower stent thrombosis than SES in long lesions; leaves open whether findings warrant stent preference in current practice.
OBJECTIVES: Long-term clinical outcomes were evaluated in long coronary artery stenosis treated with different types of drug-eluting stents. BACKGROUND: Long-term follow-up data to compare clinical outcomes between Resolute™ zotarolimus-eluting stent (R-ZES) versus sirolimus-eluting stent (SES) implantation for long coronary artery stenosis is insufficient. METHODS: A total of 254 patients (307 lesions) treated with R-ZES and 265 patients (303 lesions) treated with SES for long coronary lesions (total stent length ≥ 30 mm) were enrolled, and long-term (3 years) clinical outcomes were compared between the 2 groups. Efficacy (target lesion revascularization [TLR]) and safety (the composite occurrence of cardiovascular death, target lesion-related myocardial infarction, or target lesion-related definite stent thrombosis) were assessed. RESULTS: The 2 groups had similar baseline characteristics except for the duration of dual antiplatelet therapy (23.4 ± 11.2 months in R-ZES-treated patients vs. 27.4 ± 13.9 months in SES-treated patients, P<0.001). Total stent length was similar in R-ZES-treated patients (45.0 ± 19.0 mm) and SES-treated patients (45.4 ± 18.6 mm) (P=0.464). The cumulative TLR rate was 4.6% in R-ZES-treated patients versus 4.6% in SES-treated patients (P=0.911). For safety parameters, R-ZES-treated patients showed a significantly lower rate of the composite occurrence of cardiovascular death, target lesion-related myocardial infarction, or target lesion-related definite stent thrombosis than SES-treated patients (0.4% vs. 2.4%, P=0.042). Particularly, the occurrence of target lesion-related definite stent thrombosis was significantly lower in R-ZES-treated patients than in SES-treated patients (0.0% vs. 2.0%, P=0.028). CONCLUSIONS: R-ZES stents showed superior long-term safety than SES for treating long coronary lesions, while maintaining a similar clinical efficacy.
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Im et al. (2013) conducted a cohort in Long coronary artery stenosis (n=519). Resolute zotarolimus-eluting stent (R-ZES) vs. Sirolimus-eluting stent (SES) was evaluated on Composite occurrence of cardiovascular death, target lesion-related myocardial infarction, or target lesion-related definite stent thrombosis (p=0.042). Resolute zotarolimus-eluting stents showed superior 3-year safety compared to sirolimus-eluting stents (0.4% vs 2.4%, P=0.042), while maintaining similar efficacy for target lesion revascularization.
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