Comparison of 2-year clinical outcomes between zotarolimus-, sirolimus-, and paclitaxel-eluting stents in real life clinical practice

Authors

  • Ji-Hyun Kim MD,

    1. Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
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    • Ji-Hyun Kim and Kyung Woo Park have contributed equally to this study

  • Kyung Woo Park MD, PhD,

    1. Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
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    • Ji-Hyun Kim and Kyung Woo Park have contributed equally to this study

  • Woo-Hyun Lim MD,

    1. Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
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  • Dong-Ho Shin MD, MPH,

    1. Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
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  • Sang-Hoon Na MD, PhD,

    1. Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
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  • Bon-Kwon Koo MD, PhD,

    1. Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
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  • Tae-Jin Youn MD, PhD,

    1. Department of Internal Medicine and Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Gyenggi-do, Republic of Korea
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  • In-Ho Chae MD, PhD,

    1. Department of Internal Medicine and Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Gyenggi-do, Republic of Korea
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  • Dong-Ju Choi MD, PhD,

    Corresponding author
    1. Department of Internal Medicine and Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Gyenggi-do, Republic of Korea
    • Director of Cardiovascular Center/Professor, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyenggi-do, Republic of Korea. E-mail: djchoi@snu.ac.kr (or) Hyo-Soo Kim, MD, PhD, Director of Cardiac Catheterization Laboratory & Coronary Intervention/Director of National Research Laboratory for Cardiovascular Stem Cell/Professor, Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, 101 Daehak-no, Seoul, Korea, 110-744. E-mail: hyosoo@snu.ac.kr

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  • Hyo-Soo Kim MD, PhD

    Corresponding author
    1. Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
    • Director of Cardiovascular Center/Professor, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyenggi-do, Republic of Korea. E-mail: djchoi@snu.ac.kr (or) Hyo-Soo Kim, MD, PhD, Director of Cardiac Catheterization Laboratory & Coronary Intervention/Director of National Research Laboratory for Cardiovascular Stem Cell/Professor, Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, 101 Daehak-no, Seoul, Korea, 110-744. E-mail: hyosoo@snu.ac.kr

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  • Conflict of interest: Nothing to report. Ji-Hyun Kim and Kyung Woo Park have contributed equally to this study

Abstract

Background: There are few studies comparing the long-term efficacy and safety of the zotarolimus-eluting stent (ZES) with sirolimus- (SES) and paclitaxel-eluting stents (PES) in the unselected cohorts that were subject to real life clinical practice. Methods: Total 2,769 patient who underwent successful percutaneous coronary intervention (PCI) with the three drug-eluting stents (DES) between April 2006 and July 2008 were analyzed retrospectively. A total of 1,152 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 = 0.49–0.88, P = 0.005) or the PES group (7.6% vs. 10.2%, HR = 0.74, CI = 0.55–0.99, P = 0.048), while similar between the PES and the ZES groups (HR = 0.89, CI = 0.66–1.20, 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.Conclusions: This observational study shows that the use of SES is superior to PES or ZES for the TLF in the overall and matched analysis. © 2011 Wiley Periodicals, Inc.

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