Clinical outcomes after zotarolimus and everolimus drug eluting stent implantation in coronary artery bifurcation lesions: insights from the RESOLUTE All Comers Trial

Heart. 2013 Sep;99(17):1267-74. doi: 10.1136/heartjnl-2013-303778. Epub 2013 Jun 25.

Abstract

Objective: We investigated clinical outcomes after treatment of coronary bifurcation lesions with second generation drug eluting stents (DES).

Design: Post hoc analysis of a randomised, multicentre, non-inferiority trial.

Setting: Multicentre study.

Patients: All comers study with minimal exclusion criteria.

Interventions: Patients were treated with either zotarolimus or everolimus eluting stents. The patient population was divided according to treatment of bifurcation or non-bifurcation lesions and clinical outcomes were compared between groups.

Main outcomes measures: Clinical outcomes within 2-year follow-up.

Results: A total of 2265 patients were included in the present analysis. Two-year follow-up data were available in 2223 patients: 1838 patients in the non-bifurcation group and 385 patients in the bifurcation group. At 2-year follow-up the bifurcation and the non-bifurcation lesion groups showed no significant differences in terms of cardiac death (2.3 vs 2.1, p=0.273), target lesion failure (9.7% vs 13.8%, p=0.255), major adverse cardiac events (11.5% vs 15.1%, p=0.305), target lesion revascularisation (4.7% vs 6.0%, p=0.569), and definite or probable stent thrombosis (1.6% vs 1.8%, p=0.419).

Conclusions: The use of second generation DES for the treatment of coronary bifurcation lesions was associated with similar long term mortality and clinical outcomes compared with non-bifurcation lesions.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Coronary Angiography
  • Coronary Stenosis / mortality
  • Coronary Stenosis / therapy*
  • Drug-Eluting Stents*
  • Everolimus
  • Female
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Kaplan-Meier Estimate
  • Logistic Models
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / methods*
  • Percutaneous Coronary Intervention / mortality
  • Proportional Hazards Models
  • Prospective Studies
  • Sirolimus / analogs & derivatives*
  • Sirolimus / therapeutic use
  • Treatment Outcome

Substances

  • Immunosuppressive Agents
  • Everolimus
  • zotarolimus
  • Sirolimus