Comparison of 5-year outcomes of zotarolimus-eluting stents and everolimus-eluting stents / 中国介入心脏病学杂志

Objective To compare 5-year clinical outcomes of the safety and efficacy of zotarolimus-eluting stent(ZES)and everolimus-eluting stent(EES).Methods A total of 480 patients receiving either ZES(n=244)or EES(n=236)placement from January 2011 to December 2012 in Wuhan Asia Heart Hospital were included in this study.The primary end point of the study was 5-year all-cause mortality including acute myocardial infarction,and target vessel revascularization after the index EES/ZES placement.The secondary end points included subsequent in-stent restenosis and in-stent occlusion at 5 years.Results There were no significant differences in all-cause mortality and acute myocardial infarction outcomes between the ZES and the EES groups(P＞0.05).Compared with patients receiving EES,patients receiving ZES had a significantly higher rate of 5-year target vessel revascularization(10.2％vs.5.1％,P=0.040),in-stent restenosis(11.5％vs.5.9％,P=0.036),and in-stent occlusion(6.1％vs.2.1％,P=0.038).Conclusions At 5 years,patients receiving EES generally had better or comparable long-term outcomes compared with patients receiving ZES.

Nobori-Biolimus-Eluting Stents versus Resolute Zotarolimus-Eluting Stents in Patients Undergoing Coronary Intervention: A Propensity Score Matching

PURPOSE: To compare the 1-year outcomes of a durable polymer Zotarolimus-eluting stent (ZES) versus a biodegradable polymer Biolimus-eluting stent (BES) in patients undergoing percutaneous coronary intervention. MATERIALS AND METHODS: A total of 2083 patients from 2 different registries, 1125 treated with BES in NOBORI registry and 858 received ZES in CONSTANT registry were included in this study. Clinical outcomes were compared with the use of propensity score matching (PSM). The primary endpoint was a composite of major adverse cardiovascular and cerebrovascular events (MACCEs) including cardiac death, myocardial infarction, clinically driven target lesion revascularization and stroke. Secondary end points were individual components of MACCEs as well as the incidence of stent thrombosis at 1-year follow-up. RESULTS: After PSM, 699 matched pairs of patients (n=1398) showed no significant difference between BES and ZES in the risk of composite MACCEs at 1 year (2.6% vs. 1.7%; p=0.36). Cardiac death was not statistically different between groups (0.7% vs. 0.4%, p=0.73). Target lesion revascularization rate was also similar between BES and ZES (1.1% vs. 0.7%, p=0.579). Non-Q wave myocardial infarction, as well as target-vessel revascularization rate, was similar between the two groups (0.14% for BES and 0.72% for ZES). Both stent types were excellent with no cases of stent thrombosis and rate of Q wave myocardial infarction reported during the follow-up period. CONCLUSION: In this cohort of patients treated with BES or ZES, the rate of MACCEs at 1 year was low and significantly not different between both groups.

Comparison of clinical outcomes of domestic Sirolimus and imported Zotalimus eluting stents for unprotected left main coronary artery disease / 中国介入心脏病学杂志

Objective To evaluate the clinical efficacy and safety of domestic Sirolimus-eluting stents (Firebird) and imported Zotalimus-eluting stents ( Resolute) in the treatment of patients with unprotected left main coronary artery disease ( ULMCA) . Methods We retrospectively enrolled 76 patients with ULMCA treated by percutaneous coronary intervention (PCI) under the guidance of IVUS in our hospital. According to the different stents used in the procedure, the patients were divided into two groups: Domestic Sirolimus-Eluting Stents group (Firebird group, n = 42) and Imported Zotarolimus-Eluting Stents group (Resolute group, n = 34) . We analyzed the baseline characteristics, coronary artery lesion characteristics, stenting strategies and any changes in left ventricular ejection fraction ( LVEF) in both groups and investigated the long-term clinical outcomes. Results There were no significant differences in the baseline characteristics, the SYNTAX scores of the coronary artery lesion and the rate of complete revascularization between the two groups. Compared with that in Firebird group, there were more cases involving the distal left main (79. 4% vs. 45. 2% , P ﹤ 0. 05) and more patients using two stents strategies (29. 4% vs. 7. 1% , P ﹤ 0. 05) in the Resolute group. The change in LVEF post-PCI had no difference between the two groups. The patients were followed up for a mean of (23. 3 ± 10. 7) months. During the follow-up period, the occurrence of MACCE had no significant difference between the two groups. In the Firebird group, there were one sudden cardiac death, one nonfatal myocardial infarction, one stroke and five patients with recurrence of angina pectoris. In the Resolute group there were one sudden cardiac death, one target lesion revascularization and four patients with recurrence of angina pectoris. Conclusions Compared with the imported Zotalimus-Eluting Stents, the domestic Sirolimus-Eluting Stents are safe and effective in the treatment of patients with unprotected left main lesions under the guidance of IVUS. The two kinds of stent showed similar long-term clinical outcomes.

Zotarolimus-eluting stent-induced hypersensitivity pneumonitis

No abstract available.

Acute and Long-Term Angiographic Outcomes of Side Branch Stenosis after Randomized Treatment of Zotarolimus-, Sirolimus-, and Paclitaxel-Eluting Stent for Coronary Artery Stenosis

This was designed to assess the outcomes of side branch (SB) stenosis after implantation of three drug-eluting stents (DES). From 2,645 patients in the ZEST (Comparison of the Efficacy and Safety of Zotarolimus-Eluting Stent with Sirolimus-Eluting and PacliTaxel-Eluting Stent for Coronary Lesions) Trial, 788 patients had 923 bifurcation lesions with SB > or = 1.5 mm were included. SB was treated in 150 lesions, including 35 (3.8%) receiving SB stenting. Of untreated SB with baseline stenosis < 50%, the incidences of periprocedural SB compromise was similar in the zotarolimus (15.8%), sirolimus (17.2%), and paclitaxel (16.6%) stent groups (P = 0.92). At follow-up angiography, delayed SB compromise occurred in 13.9%, 3.2%, and 9.4% (P = 0.010) of these groups. When classified into four groups (< 50%, 50%-70%, 70%-99%, and 100%), 9.0% of untreated SB were worsened, whereas improvement and stationary were observed in 9.6% and 81.4%. In a multivariable logistic regression model, main branch (MB) stenosis at follow-up (%) was the only independent predictor of SB stenosis worsening (odds ratio, 1.03; 95% confidence interval, 1.01-1.04; P < 0.001). After MB stenting in bifurcation lesions, a minority of SB appears to worsen. DES with strong anti-restenotic efficacy may help maintain SB patency.

Simultaneous Multi-Vessel Subacute Stent Thromboses in Zotarolimus-Eluting Stents

Despite its low incidence, stent thrombosis (ST) is one of the most dreaded complications of percutaneous coronary intervention. Endeavor (Medtronics Europe SA) is a new zotarolimus-eluting stent (ZES) with a favorable safety profile that was reported in early and ongoing trials. However, few lethal stent thromboses related to this new drug eluting stent (DES) have been reported. We experienced a case of simultaneous subacute ZES thromboses, 6 days after stent implantations in the proximal left anterior descending artery and the proximal right coronary artery (RCA).