Comparison of Zotarolimus-Eluting Stents With Sirolimus- and Paclitaxel-Eluting Stents for Coronary Revascularization
- Affiliated Author(s)
- 허승호; 김기식
- Alternative Author(s)
- Hur, Seung Ho; Kim, Kee Sik
- Journal Title
- Journal of the American College of Cardiology
- ISSN
- 0735-1097
- Issued Date
- 2010
- Keyword
- angioplasty; coronary disease; stents
- Abstract
- Objectives The aim of this study was to evaluate the relative efficacy and safety of zotarolimus-eluting stents (ZES) in comparison
with the established and widely used sirolimus- (SES) and paclitaxel-eluting stents (PES) in routine clinical
practice.
Background Whether ZES might provide similar clinical and angiographic outcomes in a broad spectrum of patients compared
with SES or PES is undetermined.
Methods We performed a single-blind, multicenter, prospectively randomized trial to compare ZES with SES and PES in
2,645 patients undergoing percutaneous coronary intervention. The primary end point was a composite of major
adverse cardiac events (MACE) (death, myocardial infarction, and ischemia-driven target vessel revascularization)
at 12 months. A noninferiority comparison (ZES vs. SES) and a superiority comparison (ZES vs. PES) were
performed for the primary end point.
Results Baseline clinical and angiographic characteristics were similar in the 3 groups. At 12 months, the ZES group
showed noninferior rates of MACE compared with the SES group (10.2% vs. 8.3%, p for noninferiority = 0.01,
p for superiority = 0.17) and significantly fewer MACE than the PES group (10.2% vs. 14.1%, p for superiority
0.01). The incidence of death or myocardial infarction was similar among the groups (ZES vs. SES vs. PES, 5.8%
vs. 6.9% vs. 7.6%, respectively, p = 0.31). The incidence of stent thrombosis was significantly lower in the SES
group (ZES vs. SES vs. PES, 0.7% vs. 0% vs. 0.8%, respectively, p = 0.02).
Conclusions In this large-scale, practical randomized trial, the use of ZES resulted in similar rates of MACE compared with SES and
in fewer MACE compared with PES at 12 months.
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