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A Randomized Comparison of Platinum Chromium-Based Everolimus-Eluting Stents Versus Cobalt Chromium-Based Zotarolimus-Eluting Stents in All-Comers Receiving Percutaneous Coronary Intervention: HOST–ASSURE (Harmonizing Optimal Strategy for Treatment of Coronary Artery Stenosis–Safety & Effectiveness of Drug-Eluting Stents & Anti-platelet Regimen), a Randomized, Controlled, Noninferiority Trial

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Author(s)
Kyung Woo ParkSi-Hyuck KangHyun-Jae KangBon-Kwon KooByoung-Eun ParkKwang Soo ChaJay Young RhewHui-Kyoung JeonEun-Seok ShinJu Hyeon OhMyung-Ho JeongSanghyun KimKyung-Kuk HwangJung-Han YoonSung Yun LeeTae-Ho ParkKeon Woong MoonHyuck-Moon KwonSeung-Ho HurJae-Kean RyuBong-Ryul LeeYong Whi ParkIn-Ho ChaeHyo-Soo Kim
Keimyung Author(s)
Hur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
Journal of the American College of Cardiology
Issued Date
2014
Volume
63
Issue
25
Keyword
all-comers trialclinical outcomedrug-eluting stent(s)percutaneous coronary intervention
Abstract
Objectives This study sought to test whether the newly developed platinum chromium (PtCr)-based everolimus-eluting stent
(EES) is noninferior to the cobalt chromium (CoCr)-based zotarolimus-eluting stent (ZES) in all-comers receiving
percutaneous coronary intervention (PCI).
Background PtCr provides improved radial strength, conformability, and visibility compared with the CoCr alloy, but PtCr-based
stents have not been tested in a wide range of patients receiving PCI. Also, recent case series have raised the issue
of longitudinal stent deformation (LSD) with newer drug-eluting stents.
Methods We randomly assigned 3,755 all-comers receiving PCI to PtCr-EES or CoCr-ZES. The primary outcome was target
lesion failure (TLF) at 1-year post-PCI, defined as the composite of cardiac death, nonfatal target vessel–related
myocardial infarction, and ischemia-driven target lesion revascularization. Post-hoc angiographic analysis was
performed to qualitatively and quantitatively analyze LSD.
Results At 1 year, TLF occurred in 2.9% and 2.9% of the population in the PtCr-EES and CoCr-ZES groups, respectively
(superiority p ¼ 0.98, noninferiority p ¼ 0.0247). There were no significant differences in the individual components
of TLF as well as the patient-oriented clinical outcome. Of 5,010 stents analyzed, LSD occurred in 0.2% and 0% in
the PtCr-EES and CoCr-ZES groups, respectively (p ¼ 0.104). There was no significant difference in post-deployment
stent length ratio between the 2 stents (p ¼ 0.352).
Conclusions At 1 year, PtCr-EES was noninferior to CoCr-ZES in all-comers receiving PCI. Although LSD was observed only in PtCr-
EES, both the stent length ratio and the frequency of LSD were not significantly different between the 2 stent types,
and PtCr-EES was not associated with adverse clinical outcomes. (Harmonizing Optimal Strategy for Treatment of
Coronary Artery Stenosis–SAfety & EffectiveneSS of Drug-ElUting Stents & Anti-platelet REgimen .
Keimyung Author(s)(Kor)
허승호
Publisher
School of Medicine
Citation
Kyung Woo Park et al. (2014). A Randomized Comparison of Platinum Chromium-Based Everolimus-Eluting Stents Versus Cobalt Chromium-Based Zotarolimus-Eluting Stents in All-Comers Receiving Percutaneous Coronary Intervention: HOST–ASSURE (Harmonizing Optimal Strategy for Treatment of Coronary Artery Stenosis–Safety & Effectiveness of Drug-Eluting Stents & Anti-platelet Regimen), a Randomized, Controlled, Noninferiority Trial. Journal of the American College of Cardiology, 63(25), 2805–2816. doi: 10.1016/j.jacc.2014.04.013
Type
Article
ISSN
0735-1097
DOI
10.1016/j.jacc.2014.04.013
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33718
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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