Comparison of two-year clinical outcomes between zotarolimus-, sirolimus-, and paclitaxel-eluting stents in real life clinical practice

Catheterization and Cardiovascular Interventions, 05/03/2012

This observational study shows that the use of SES is superior to paclitaxel–eluting stents (PES) or zotarolimus–eluting stent (ZES) for the target–lesion failure (TLF) in the overall and matched analysis.

Methods

  • Total 2769 patient who underwent successful percutaneous coronary intervention (PCI) with the three drug eluting stents (DES) between April 2006 and July 2008, were analyzed retrospectively.
  • 1152 patients were treated with SES, 810 with PES, and 807 with ZES.
  • The primary analysis endpoint was cumulative rate of target–lesion failure (TLF) at 24 months, defined as the composite of cardiac death, target–vessel related myocardial infarction (MI), and target–lesion revascularization (TLR).

Results

  • At 24 months, the incidence of TLF was significantly lower in the SES group compared with the ZES (7.6% vs. 11.3%, HR=0.66, CI 0.49 to 0.88, P=0.005) or the PES group (7.6% vs. 10.2%, HR=0.74, CI 0.55 to 0.99, P=0.048), while similar between the PES and the ZES groups (HR=0.89, CI 0.66 to 1.20, P=0.443).
  • The difference was mostly driven by higher rate of TLR in the ZES and PES groups compared with the SES group, mostly within the first year post–PCI.
  • However, the rate of hard endpoints (cardiac death or nonfatal MI) was similar among the three groups.
  • These results were reproduced in the propensity score–matched cohort.

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