Zotarolimus- & everolimus-eluting stents yield similar outcomes

Zotarolimus-eluting stents (ZES) and everolimus-eluting stents (EES) led to comparable clinical and angiographic outcomes after one year of treatment for unprotected left main coronary artery (uLMCA) disease in a study published online Aug. 21 in the Journal of the American College of Cardiology.

A team of German and Italian researchers evaluated both stents in a population of patients with symptomatic coronary artery disease undergoing PCI due to uLMCA lesions. The participants were all older than 18 years and were recruited between 2007 and 2011 at four medical centers in Germany and Italy.

This study “is the only and the largest specifically designed to randomly compare ZES with EES for treatment of uLMCA lesions,” noted the authors, led by Julinda Mehilli, MD, of Munich University Clinic.

The researchers randomly assigned 324 patients to the ZES group and 326 to the EES group.

As the primary outcome, they determined how many deaths, heart attacks and target lesion revascularizations occurred one year later. They also determined definite or probable stent thrombosis after one year and angiographic restenosis based on an analysis of the LMCA area.

“At one year, the cumulative incidence of primary endpoint was 17.5 percent in the ZES and 14.3 percent in the EES group,” wrote the authors.

Three ZES patients and two EES patients experienced definite or probable stent thrombosis. All-cause mortality was equal in both groups at 5.6 percent. Angiography revealed restenosis in 21.5 percent of ZES patients and 16.8 percent of EES patients.

“The main findings of the present study were that both ZES and EES are associated with an excellent procedural success rate, and perform similar[ly] regarding safety and efficacy in this large cohort of relatively nonselected patients wit uLMCA disease,” the authors explained.