Randomized, double-blind, multicenter study of the Endeavor zotarolimus-eluting phosphorylcholine-encapsulated stent for treatment of native coronary artery lesions. Clinical and angiographic results of the ENDEAVOR II Trial.
OBJECTIVE
The use of the Endeavor stent might reduce restenosis and stent thrombosis at 9 months.


METHODS
Patients (n =1,197) treated for single coronary artery stenosis were enrolled in a prospective, randomized, double-blind study and randomly assigned to receive the Endeavor zotarolimus-eluting phosphorylcholine polymer-coated stent (n= 598) or the same bare metal stent but without the drug or the polymer coating (n=599).


RESULTS
The 2 groups were well matched in baseline characteristics. Diabetes was present in 20.1% of patients; the mean reference vessel diameter was 2.75 mm; and the mean lesion length was 14.2 mm. The primary end point of target vessel failure at 9 months was reduced from 15.1% with the bare metal stent to 7.9% with the Endeavor (P=0.0001), and the rate of major adverse cardiac events was reduced from 14.4% with the bare metal stent to 7.3% with the Endeavor (P=0.0001). Target lesion revascularization was 4.6% with Endeavor compared with 11.8% with the bare metal stent (P=0.0001). The rate of stent thrombosis was 0.5% with the Endeavor, which was not significantly different from 1.2% with the bare metal stent. In 531 patients submitted to angiographic follow-up, late loss was reduced from 1.03+/-0.58 to 0.61+/-0.46 (P<0.001) in stent and from 0.72+/-0.61 to 0.36+/-0.46 (P<0.001) in segment. The rate of in-segment restenosis was reduced from 35% to 13.2% with Endeavor (P<0.0001). There was no excessive edge stenosis, aneurysm formation, or late acquired malposition by intravascular ultrasound imaging. Differences in clinical outcome were maintained at 12 and 24 months (P<0.0001).


CONCLUSIONS
Compared with bare metal stents, the Endeavor stent is safe and reduces the rates of clinical and angiographic restenosis at 9, 12, and 24 months.
Fajadet
J
J
Clinique Pasteur, Toulouse, France.
Wijns
W
W
Laarman
G-J
GJ
Kuck
K-H
KH
Ormiston
J
J
Münzel
T
T
Popma
J J
JJ
Fitzgerald
P J
PJ
Bonan
R
R
Kuntz
R E
RE
D000368:Aged; D001315:Australia; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000517:prevention & control*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D004311:Double-Blind Method; D016503:Drug Delivery Systems; D004867:Equipment Design; D005060:Europe; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010139:Pacific Islands; D010767:Phosphorylcholine; D011446:Prospective Studies; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015607:Stents; D016896:Treatment Outcome
D002317:Cardiovascular Agents; D010767:Phosphorylcholine; C489443:zotarolimus; D020123:Sirolimus