title: Comparison of zotarolimus-eluting stents with sirolimus-eluting and paclitaxel-eluting stents: intimal hyperplasia and vascular changes assessed by volumetric intravascular ultrasound analysis.
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.
  
  
  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.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT00418067.
authors.affiliation: Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Soo-Jin
authors.initials: SJ
authors.lastname: Kang
authors.forename: Gary S
authors.initials: GS
authors.lastname: Mintz
authors.forename: Duk-Woo
authors.initials: DW
authors.lastname: Park
authors.forename: Seung-Whan
authors.initials: SW
authors.lastname: Lee
authors.forename: Young-Hak
authors.initials: YH
authors.lastname: Kim
authors.forename: Cheol Whan
authors.initials: CW
authors.lastname: Lee
authors.forename: Ki-Hoon
authors.initials: KH
authors.lastname: Han
authors.forename: Jae-Joong
authors.initials: JJ
authors.lastname: Kim
authors.forename: Seong-Wook
authors.initials: SW
authors.lastname: Park
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives; D017539:Tunica Intima / Q000473:pathology*; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: C489443:zotarolimus; D017239:Paclitaxel; D020123:Sirolimus