Three-year patient-related and stent-related outcomes of second-generation everolimus-eluting Xience V stents versus zotarolimus-eluting resolute stents in real-world practice (from the Multicenter Prospective EXCELLENT and RESOLUTE-Korea Registries)
- Abstract
- Long-term outcomes are imperative to confirm safety of drug-eluting stents. There have been 2 randomized controlled trials comparing everolimus-eluting stents (EESs) and Resolute zotarolimus-eluting stents (ZES-Rs). To date, long-term clinical outcomes of these stents were limited to only 1 report, which has recently reported 4-year comparisons of these stents. Therefore, more evidence is needed regarding long-term clinical outcomes of the second-generation stents. This study compared the long-term clinical outcomes of EES with ZES-R in all-comer" cohorts up to 3-year follow-up. The EXCELLENT and RESOLUTE-Korea registries prospectively enrolled 3,056 patients treated with EES and 1,998 with ZES-R, respectively, without exclusions. Stent-related composite outcomes (target lesion failure) and patient-related composite events up to 3-year follow-up were compared in crude and propensity score-matched analyses. Of 5,054 patients, 3,830 patients (75.8%) had off-label indication (2,217 treated with EES and 1,613 treated with ZES-R). The stent-related outcome (189 [6.2%] vs 127 [6.4%], p= 0.812) and the patient-related outcome (420 [13.7%] vs 250 [12.5%], p= 0.581) did not differ between EES and ZES-R, respectively, at 3years, which was corroborated by similar results from the propensity score-matched cohort (hazard ratio [HR] 0.92, 95% confidence interval [CI] 0.70 to 1.20, p= 0.523 and 0.85, 95% CI 0.70 to 1.02, p= 0.081, for stent- and patient-related outcomes, respectively). The rate of definite or probable stent thrombosis up to 3years (22 [0.7%] vs 10 [0.5%], p=0.370) was also similar. The rate of very late definite or probable stent thrombosis was very low and comparable between the 2 stents (3 [0.1%] vs 1 [0.1%], p= 0.657). In multivariate analysis, chronic renal failure (adjusted HR 3.615, 95% CI 2.440 to 5.354, p<0.001) and off-label indication (adjusted HR 1.782, 95% CI 1.169 to 2.718, p= 0.007) were the strongest predictors of target lesion failure at 3 years. In conclusion, both stents showed comparable safety and efficacy at 3-year follow-up in this robust real-world registry with unrestricted use of EES and ZES-R. Overall incidences of target lesion failure and definite stent thrombosis, including very late stent thrombosis, were low, even in the patients with off-label indications, suggesting excellent long-term safety and sustained efficacy of both types of second-generation drug-eluting stents."
- All Author(s)
- J. M. Lee
; K. W. Park
; J. K. Han
; H. M. Yang
; H. J. Kang
; B. K. Koo
; J. W. Bae
; S. I. Woo
; J. S. Park
; D. K. Jin
; D. W. Jeon
; S. K. Oh
; D. I. Kim
; M. S. Hyon
; H. K. Jeon
; D. S. Lim
; M. G. Kim
; S. W. Rha
; S. H. Her
; J. Y. Hwang
; S. Kim
; Y. J. Choi
; J. H. Kang
; K. W. Moon
; Y. Jang
; H. S. Kim
- Issued Date
- 2014
- Type
- Article
- Keyword
- Antineoplastic Agents; Coronary Angiography; Coronary Artery Disease/diagnostic imaging/mortality/*surgery; *Drug-Eluting Stents; Electrocardiography; Everolimus; Female; Follow-Up; Studies; Humans; Immunosuppressive; Agents/pharmacology; Male; Middle Aged; Percutaneous Coronary Intervention/*methods; Prospective Studies; Prosthesis; Design; *Registries; Republic of Korea/epidemiology; Sirolimus/*analogs & derivatives/pharmacology; Survival; Rate/trends; Time Factors; Treatment Outcome
- Publisher
- American College of Cardiology
- ISSN
- 0002-9149
- Citation Title
- The American Journal of Cardiology
- Citation Volume
- 114
- Citation Number
- 9
- Citation Start Page
- 1329
- Citation End Page
- 1338
- Language(ISO)
- eng
- DOI
- 10.1016/j.amjcard.2014.07.065
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/1179
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