OBJECTIVES: The aim of this study was to investigate the impact of patient and lesion complexity on outcomes with newer-generation zotarolimus-eluting stents (ZES) and everolimus-eluting stents (EES). BACKGROUND: Clinical and angiographic outcomes of newer-generation stents have not been described among complex patients. METHODS: Patients enrolled in the RESOLUTE All Comers trial (A Randomized Comparison of a Zotarolimus-Eluting Stent With an Everolimus-Eluting Stent for Percutaneous Coronary Intervention) were stratified into "complex" and "simple." RESULTS:Of 2,292 patients, 1,520 (66.3%) were complex and treated with ZES (n = 764) or EES (n = 756). Event rates were higher among complex patients, and results did not differ between ZES and EES, regardless of complexity. At 1 year, target lesion failure was 8.9% in ZES- and 9.7% in EES-treated complex patients (p = 0.66) and 6.8% in ZES- and 5.7% in EES-treated simple patients (p = 0.55). Rates of cardiac death (1.3% vs. 2.2%, p = 0.24), target-vessel myocardial infarction (4.3% vs. 4.4%, p = 0.90), and clinically indicated target lesion revascularization (4.4% vs. 4.0%, p = 0.80) were similar for both stent types among complex patients. Definite or probable stent thrombosis occurred in 20 (1.3%) complex patients with no difference between ZES (1.7%) and EES (0.9%, p = 0.26). Angiographic follow-up showed similar results for ZES and EES in terms of in-stent percentage diameter stenosis (22.2 ± 15.4% vs. 21.4 ± 15.8%, p = 0.67) and in-segment binary restenosis (6.6% vs. 8.0%, p = 0.82) in the complex group. CONCLUSIONS: In this all-comers randomized trial, major adverse cardiovascular events were more frequent among complex than simple patients. The newer-generation ZES and EES proved to be safe and effective, regardless of complexity, with similar clinical and angiographic outcomes for both stent types through 1 year. (RESOLUTE-III All Comers Trial: A Randomized Comparison of a Zotarolimus-Eluting Stent With an Everolimus-Eluting Stent for Percutaneous Coronary Intervention; NCT00617084).
RCT Entities:
OBJECTIVES: The aim of this study was to investigate the impact of patient and lesion complexity on outcomes with newer-generation zotarolimus-eluting stents (ZES) and everolimus-eluting stents (EES). BACKGROUND: Clinical and angiographic outcomes of newer-generation stents have not been described among complex patients. METHODS:Patients enrolled in the RESOLUTE All Comers trial (A Randomized Comparison of a Zotarolimus-Eluting Stent With an Everolimus-Eluting Stent for Percutaneous Coronary Intervention) were stratified into "complex" and "simple." RESULTS: Of 2,292 patients, 1,520 (66.3%) were complex and treated with ZES (n = 764) or EES (n = 756). Event rates were higher among complex patients, and results did not differ between ZES and EES, regardless of complexity. At 1 year, target lesion failure was 8.9% in ZES- and 9.7% in EES-treated complex patients (p = 0.66) and 6.8% in ZES- and 5.7% in EES-treated simple patients (p = 0.55). Rates of cardiac death (1.3% vs. 2.2%, p = 0.24), target-vessel myocardial infarction (4.3% vs. 4.4%, p = 0.90), and clinically indicated target lesion revascularization (4.4% vs. 4.0%, p = 0.80) were similar for both stent types among complex patients. Definite or probable stent thrombosis occurred in 20 (1.3%) complex patients with no difference between ZES (1.7%) and EES (0.9%, p = 0.26). Angiographic follow-up showed similar results for ZES and EES in terms of in-stent percentage diameter stenosis (22.2 ± 15.4% vs. 21.4 ± 15.8%, p = 0.67) and in-segment binary restenosis (6.6% vs. 8.0%, p = 0.82) in the complex group. CONCLUSIONS: In this all-comers randomized trial, major adverse cardiovascular events were more frequent among complex than simple patients. The newer-generation ZES and EES proved to be safe and effective, regardless of complexity, with similar clinical and angiographic outcomes for both stent types through 1 year. (RESOLUTE-III All Comers Trial: A Randomized Comparison of a Zotarolimus-Eluting Stent With an Everolimus-Eluting Stent for Percutaneous Coronary Intervention; NCT00617084).
Authors: Guy F A Prado; Expedito E Ribeiro; Pedro H M C Melo; Fabio A Pinton; Antonio Esteves-Filho; Celso K Takimura; Jose Mariani; Luiz J Kajita; Gilberto Marchiori; Breno de Alencar Araripe Falcao; Micheli Z Galon; Paulo R Soares; Silvio Zalc; Pedro A Lemos Journal: Cardiovasc Diagn Ther Date: 2015-12
Authors: Maik J Grundeken; Hector M Garcia-Garcia; Robin P Kraak; P Woudstra; Daniel M de Bruin; Ton G van Leeuwen; Karel T Koch; Jan G Tijssen; Robbert J de Winter; Joanna J Wykrzykowska Journal: Int J Cardiovasc Imaging Date: 2014-07-26 Impact factor: 2.357
Authors: Joseph P Kilroy; Ali H Dhanaliwala; Alexander L Klibanov; Douglas K Bowles; Brian R Wamhoff; John A Hossack Journal: Ann Biomed Eng Date: 2015-04-17 Impact factor: 3.934
Authors: David E Kandzari; Pieter C Smits; Michael P Love; Ori Ben-Yehuda; Shmuel Banai; Simon D Robinson; Michael Jonas; Ran Kornowski; Rodrigo Bagur; Andres Iniguez; Haim Danenberg; Robert Feldman; Rajiv Jauhar; Harish Chandna; Manish Parikh; Gidon Y Perlman; Mercedes Balcells; Peter Markham; Melek Ozgu Ozan; Philippe Genereux; Elazer R Edelman; Martin B Leon; Gregg W Stone Journal: Circulation Date: 2017-08-09 Impact factor: 29.690
Authors: Yongcheol Kim; Sung Sik Oh; Myung Ho Jeong; Youngkeun Ahn; Ju Han Kim; Young Joon Hong; Doo Sun Sim; Min Chul Kim; Hyo-Soo Kim; Kyeong Ho Yun; Seok Kyu Oh; Chong Jin Kim; Myeong Chan Cho Journal: Cardiol J Date: 2018-05-10 Impact factor: 2.737