Abstract 15655: Comparison of Clinical Outcomes between Zotarolimus-, Sirolimus, and Paclitaxel-eluting Stents in Real Life Clinical Practice.
Background: There are few studies comparing the long term efficacy and safety of the second generation zotarolimus-eluting stents (ZES) with first generation sirolimus- (SES) and paclitaxel-eluting stents (PES) in an unselected cohort that were subject to real life clinical practice.
Methods: Total 2769 patients (mean age 64±11years) who underwent successful PCI with the three DES between April 2006 and July 2008 at two centers, were analyzed retrospectively. 1152 patients were treated with SES, 810 with PES, and 807 with ZES. The primary analysis variable was cumulative rate of target-lesion failure (TLF) at 18months, defined as the composite of cardiac death, target-lesion related myocardial infarction, and ischemia driven target-lesion revascularization (TLR).
Results: Baseline clinical and immediate post-procedure angiographic characteristics were similar in the three groups except for the proportion of patients with acute coronary syndrome , which was higher in the ZES group. TLF rate was significantly lower in the SES group compared with the ZES group (5.6% vs. 9.8%, P = 0.001, HR =0.56, CI 0.40 – 0.78), while similar between the PES and ZES group (9.1% vs. 9.8%, P = 0.584, HR =0.92, CI 0.67 – 1.26) (Figure 1). This was mostly driven by the higher rate of ischemia-driven TLR in the ZES and PES groups compared with the SES group. The rate of hard endpoints such as the composite of cardiac death and target lesion associated myocardial infarction, or stent thrombosis was similar between the three groups, although numerically was the highest in the ZES group.
Conclusions: This study shows that the use of ZES in an unselected Asian population in real life clinical practice, may be as safe and effective as PES, and may be as safe as but less effective than SES.
- © 2010 by American Heart Association, Inc.