Abstract
BackgroundData on clinical outcomes among patients treated with the zotarolimus-eluting Endeavor™ stent versus the sirolimus-eluting Cypher™ stent favor the sirolimus-eluting stent. However, a separate comparison of clinical outcome among patients treated for multiple lesions with these stents is lacking. We performed this comparison within the SORT OUT III trial data set.MethodsAmong 2332 patients randomized in SORT OUT III, 695 were treated for multiple lesions with zotarolimus-eluting (n = 350) or sirolimus-eluting (n = 345) stents and followed for 18 months. Major adverse cardiac events (MACE); composite of cardiac death, myocardial infarction, or target vessel revascularization (TVR); was the primary endpoint.ResultsZotarolimus-eluting compared to sirolimus-eluting stent treatment was associated with increased MACE rate (13.2% vs. 2.6%; hazard ratio 5.29 with 95% confidence interval: 2.59-10.8). All secondary endpoints; all cause death, cardiac death, myocardial infarction, TVR, target lesion revascularization, in-stent restenosis, and definite stent thrombosis; were observed more frequently among zotarolimus-eluting stent treated patients. For all endpoints, hazard ratios were 1.6 to 4.6 times higher than in the overall results of the SORT OUT III trial.ConclusionsWe observed better clinical outcomes among patients treated for multiple lesions with the sirolimus-eluting stent compared to those treated with the zotarolimus-eluting stent.
Highlights
Data on clinical outcomes among patients treated with the zotarolimus-eluting EndeavorTM stent versus the sirolimus-eluting CypherTM stent favor the sirolimus-eluting stent
Percutaneous coronary intervention (PCI) with drug eluting stent (DES) of multiple coronary artery lesions, concomitantly, has increased, and PCI of multiple lesions in patients with multivessel disease is under evaluation as an alternative or supplement to coronary artery bypass surgery [2]
Baseline patient characteristics were wellbalanced between the zotarolimus-eluting and sirolimuseluting stent groups with the exception of previous PCI which was more common among those receiving zotarolimus-eluting stents (Table 1)
Summary
Data on clinical outcomes among patients treated with the zotarolimus-eluting EndeavorTM stent versus the sirolimus-eluting CypherTM stent favor the sirolimus-eluting stent. A separate comparison of clinical outcome among patients treated for multiple lesions with these stents is lacking. We performed this comparison within the SORT OUT III trial data set. Percutaneous coronary intervention (PCI) with drug eluting stent (DES) implantation in single coronary artery lesions has become mainstay [1]. In some stent trials with comparison of zotarolimuseluting and sirolimus-eluting stents, stent safety and efficacy have only been evaluated in patients with single lesions [3].
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