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Comparison of Zotarolimus-Eluting Stents With Sirolimus-Eluting and Paclitaxel-Eluting Stents
- Source :
- Circulation: Cardiovascular Interventions. 4:139-145
- Publication Year :
- 2011
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2011.
-
Abstract
- Background— As a substudy of the large, randomized ZEST (Comparison of the Efficacy and Safety of Zotarolimus-Eluting Stent with Sirolimus-Eluting and PacliTaxel-Eluting Stent for Coronary Lesions) trial comparing first- and second-generation drug-eluting stents, we evaluated intimal hyperplasia (IH) and vascular changes using volumetric intravascular ultrasound analysis. Methods and Results— Complete angiographic and volumetric intravascular ultrasound data immediately after stenting and at 9-month follow-up were available in 162 patients with 183 lesions: 61 sirolimus-eluting stents (SES), 64 paclitaxel-eluting stents (PES), and 58 zotarolimus-eluting stents (ZES). External elastic membrane, stent, lumen, and peristent plaque volumes (external elastic membrane minus stent) were normalized by stent length. Percent IH volumes were calculated as [IH volume/stent volume]×100, %. Reduction of minimal luminal area) was greater in PES than SES (−1.4±1.5 mm 2 versus −0.7±0.9 mm 2 , P =0.003), whereas minimal luminal area change in ZES was not significantly different from SES (−1.2±1.0 mm 2 versus −0.7±0.9 mm 2 , P =0.055). Percent IH volume was less in SES compared with PES (9.8±6.0% versus 17.5±11.2%, P =0.002) or with ZES (9.8±6.0% versus 18.2±7.6%, P =0.005). Comparing ZES versus PES, there were no significant differences in %IH volume (17.5±11.2% versus 18.2±7.6%, P =0.779) or changes in normalized lumen volume (−1.2±1.3 mm 2 versus −1.1±0.8 mm 2 , P =0.452). Late stent malapposition was identified in 8 (13%) SES and 2 (3%) PES but in no ZES ( P =0.050). Angiographic restenosis was detected in 6 lesions (3 PES and 3 ZES). Conclusions— The degree of neointimal growth in ZES was similar to that in PES but less than that in SES. ZES had no late stent malappositions. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00418067.
- Subjects :
- Male
medicine.medical_specialty
Intimal hyperplasia
Paclitaxel
medicine.medical_treatment
Lumen (anatomy)
Coronary Angiography
Restenosis
Angioplasty
Intravascular ultrasound
medicine
Humans
Zotarolimus
Angioplasty, Balloon, Coronary
Ultrasonography, Interventional
Aged
Sirolimus
Hyperplasia
medicine.diagnostic_test
business.industry
Stent
Drug-Eluting Stents
Middle Aged
medicine.disease
Coronary Vessels
Angiography
Female
Radiology
Tunica Intima
Cardiology and Cardiovascular Medicine
business
medicine.drug
Subjects
Details
- ISSN :
- 19417632 and 19417640
- Volume :
- 4
- Database :
- OpenAIRE
- Journal :
- Circulation: Cardiovascular Interventions
- Accession number :
- edsair.doi.dedup.....52f135d04f4df55b500325b0d8a2615a