title: Comparison between zotarolimus-eluting stents and first generation drug-eluting stents in the treatment of patients with acute ST-segment elevation myocardial infarction.
abstract: BACKGROUND
  The purpose of this study was to compare the two year efficacy and safety of zotarolimus-eluting stents (ZES) and first-generation DES, sirolimus- (SES) and paclitaxel-eluting stents (PES), in an all-comer registry receiving primary percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI).
  
  
  METHODS
  A total of 711 consecutive STEMI patients (ZES: 135, SES: 427, and PES: 149), who underwent primary PCI between January 2005 and June 2008 were enrolled from three centers. In our study, the efficacy analysis endpoint was target vessel failure (cardiac death, target vessel related myocardial infarction, and ischemia-driven target vessel revascularization) at 2 years. The safety analysis endpoint was a composite of all cause death, non-fatal myocardial infarction, and stent thrombosis within 2 years.
  
  
  RESULTS
  At 2 years, the rates of target vessel failure in the ZES, SES, and PES groups were 14.8%, 12.9%, and 19.5%, respectively (p=0.141). The rates of composite safety endpoints at 2 years were not different among the three groups (ZES 8.1% vs. SES 13.1% vs. PES 16.8%, p=0.102). However, when comparing the two groups, ZES was safer than PES (adjusted HR 0.48, 95% CI 0.24-0.98, p=0.046). There was also a non-significant trend in favor of ZES in the rate of stent thrombosis (ZES 1.5% vs. SES 2.3% vs. PES 4.7%, p=0.186).
  
  
  CONCLUSIONS
  In the treatment of STEMI patients, ZES showed similar and acceptable efficacy compared to first-generation DES (SES and PES) up to 2 years. In addition, ZES seems to be more favorable than PES in terms of safety.
authors: Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Republic of Korea.
authors: Kyung Woo
authors: KW
authors: Park
authors: Woo-Hyun
authors: WH
authors: Lim
authors: Ji-Hyun
authors: JH
authors: Kim
authors: Si-Hyuck
authors: SH
authors: Kang
authors: Jung-Won
authors: JW
authors: Seo
authors: Young Bin
authors: YB
authors: Song
authors: Joo-Yong
authors: JY
authors: Hahn
authors: Hae-Young
authors: HY
authors: Lee
authors: Hyun-Jae
authors: HJ
authors: Kang
authors: Young-Seok
authors: YS
authors: Cho
authors: Tae-Jin
authors: TJ
authors: Youn
authors: Bon-Kwon
authors: BK
authors: Koo
authors: Seung-Hyuk
authors: SH
authors: Choi
authors: In-ho
authors: IH
authors: Chae
authors: Hyeon-Cheol
authors: HC
authors: Gwon
authors: Dong-Ju
authors: DJ
authors: Choi
authors: Hyo-Soo
authors: HS
authors: Kim
mesh_terms: D000368:Aged; D054855:Drug-Eluting Stents / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery*; D017239:Paclitaxel / Q000008:administration & dosage*; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation / Q000379:methods / Q000592:standards; D012042:Registries; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D016896:Treatment Outcome
chemical_list: C489443:zotarolimus; D017239:Paclitaxel; D020123:Sirolimus