Zotarolimus-eluting stents showed similar 12-month MACE rates compared to sirolimus-eluting and paclitaxel-eluting stents in STEMI patients undergoing primary PCI (5.9% vs 3.4% vs 5.7%; P=0.457).
RCT (n=611)
single-blind
randomly assigned
Yes
Do zotarolimus-eluting stents reduce major adverse cardiac events compared to sirolimus-eluting stents or paclitaxel-eluting stents in patients with STEMI undergoing primary PCI?
In patients with STEMI undergoing primary PCI, zotarolimus-eluting stents showed similar rates of MACE at 12 months compared to sirolimus- and paclitaxel-eluting stents, though SES showed a trend toward lower TLR.
Absolute Event Rate: 5.9% vs 3.4%
p-value: p=0.457
AIMS: The aim of this study was to compare the efficacy and safety of zotarolimus-eluting stents (ZES), sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). METHODS AND RESULTS: This study was a prospective, single-blind, multicentre, randomised trial. The primary endpoint was major adverse cardiac events (MACE) at 12 months post-procedure, defined as cardiac death, recurrent myocardial infarction (MI), or ischaemia-driven target lesion revascularisation (TLR). An angiographic substudy was performed at nine months among 348 patients. From October 2006 to April 2008, 611 patients with STEMI undergoing primary PCI were randomly assigned to treatment with ZES (n=205), SES (n=204), or PES (n=202). The cumulative incidence of MACE was 5.9% in the ZES group, 3.4% in the SES group and 5.7% in the PES group at 12-month follow-up (p=0.457). There was a trend towards a lower rate of ischaemia-driven TLR at 12- (p=0.092) and 18-month (p=0.080) follow-up in the SES group compared to the ZES and PES groups. No difference was observed in rates of cardiac death, recurrent MI and combined death and/or recurrent MI among three groups at 12- and 18-month follow-up. The rate of stent thrombosis was similar among the three groups (2.0% in each group, p=1.000). CONCLUSIONS: As compared with SES and PES, the use of ZES in patients with STEMI undergoing primary PCI, showed similar rates of MACE, cardiac death and recurrent MI at 12 and 18 months. There was a trend towards a higher rate of TLR with ZES or PES compared to SES.
Kang et al. (2011) conducted an RCT in ST-segment elevation myocardial infarction (STEMI) (n=611). Zotarolimus-eluting stents (ZES) vs. Sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) was evaluated on major adverse cardiac events (MACE) at 12 months post-procedure, defined as cardiac death, recurrent myocardial infarction (MI), or ischaemia-driven target lesion revascularisation (TLR) (p=0.457). Zotarolimus-eluting stents showed similar 12-month MACE rates compared to sirolimus-eluting and paclitaxel-eluting stents in STEMI patients undergoing primary PCI (5.9% vs 3.4% vs 5.7%; P=0.457).