Comparison of outcomes between Zotarolimus- and sirolimus-eluting stents in patients with ST-segment elevation acute myocardial infarction.
Zotarolimus-eluting stents (ZESs) demonstrated greater in-segment late luminal loss and in-segment binary restenosis rates compared to sirolimus-eluting stents (SESs) in several studies. However, no data are available in direct comparison between the clinical outcomes of the 2 stents in unselected patients with ST-segment elevation acute myocardial infarction (STEMI). The aim of the present study was to compare the clinical outcomes of ZESs and SESs in real-world patients with STEMI. A total of 873 patients with STEMI (306 patients in the ZES group and 567 patients in the SES group) were enrolled in a nationwide prospective Korea Acute Myocardial Infarction Registry (KAMIR) from January 2007 to January 2008. The primary end points were major adverse cardiac events, a composite of all causes of death, myocardial infarction, and target lesion revascularization during a 12-month clinical follow-up. During 1 year of follow-up, the primary end points occurred in 140 patients (16.0%). The use of glycoprotein IIb/IIIa inhibitors and the occurrence of multivessel disease were more common in the SES group. The SES group had a significantly lower incidence of major adverse cardiac events (hazard ratio [HR] 1.52, 95% confidence interval [CI] 1.07 to 2.16, p = 0.02), target lesion revascularization (HR 2.16, 95% CI 1.01 to 4.59, p = 0.046), and target vessel revascularization (HR 2.24, 95% CI 1.18 to 4.24, p = 0.013). However, no significant differences were found in death or myocardial infarction (HR 1.37, 95% CI 0.91 to 2.05, p = 0.129). In conclusion, SESs provided superior angiographic outcomes, translating into better clinical outcomes and negating any change in STEMI patient safety profiles compared to ZESs.
Kim
Hyun Kuk
HK
Chonnam National University Hospital, Gwangju, South Korea. myungho@chollian.net
Jeong
Myung Ho
MH
Ahn
Young Keun
YK
Kim
Jong Hyun
JH
Chae
Shung Chull
SC
Kim
Young Jo
YJ
Hur
Seung Ho
SH
Seong
In Whan
IW
Hong
Taek Jong
TJ
Choi
Dong Hoon
DH
Cho
Myeong Chan
MC
Kim
Chong Jin
CJ
Seung
Ki Bae
KB
Chung
Wook Sung
WS
Jang
Yang Soo
YS
Rha
Seung Woon
SW
Bae
Jang Ho
JH
Cho
Jeong Gwan
JG
Park
Seung Jung
SJ
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging; D054855:Drug-Eluting Stents / Q000009:adverse effects; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D020123:Sirolimus / Q000031:analogs & derivatives*; D013927:Thrombosis / Q000000981:diagnostic imaging
C489443:zotarolimus; D020123:Sirolimus