title: Zotarolimus- versus everolimus-eluting stents for unprotected left main coronary artery disease.
abstract: OBJECTIVE
  This study sought to compare the safety and efficacy of the zotarolimus-eluting stent (ZES) and the everolimus-eluting stent (EES) for treatment of unprotected left main coronary artery (uLMCA) disease.
  
  
  BACKGROUND
  The second-generation ZES and EES have reduced the risk of restenosis in large patient cohorts. However, their comparative performance in uLMCA lesions is not known.
  
  
  METHODS
  In this study, patients with symptomatic coronary artery disease undergoing percutaneous coronary intervention for uLMCA lesions were randomly assigned to receive either a ZES (n = 324) or an EES (n = 326). The primary endpoint was the combined incidence of death, myocardial infarction, and target lesion revascularization at 1 year. Secondary endpoints were definite or probable stent thrombosis at 1 year and angiographic restenosis based on analysis of the left main coronary artery area at follow-up angiography.
  
  
  RESULTS
  At 1 year, the cumulative incidence of the primary endpoint was 17.5% in the ZES group and 14.3% in the EES group (relative risk: 1.26; 95% confidence interval [CI]: 0.85 to 1.85; p = 0.25). Three patients in the ZES group (0.9%) and 2 patients in the EES group (0.6%) experienced definite or probable stent thrombosis (p > 0.99). All-cause mortality at 1 year was equal in the 2 groups (5.6%; relative risk: 1.00; 95% CI: 0.52 to 1.93; p = 0.98). Angiographic restenosis occurred in 21.5% of patients in the ZES group and 16.8% in the EES group (relative risk: 1.28; 95% CI: 0.86 to 1.92; p = 0.24).
  
  
  CONCLUSIONS
  Within the statistical limitations of the present study, treatment of uLMCA lesions with a ZES or an EES provided comparable clinical and angiographic outcomes at 1-year follow-up.
authors: Klinikum der Universität Munich, Ludwig-Maximilian University, Munich, Germany. Electronic address: julinda.mehilli@med.uni-muenchen.de.
authors: Julinda
authors: J
authors: Mehilli
authors: Gert
authors: G
authors: Richardt
authors: Marco
authors: M
authors: Valgimigli
authors: Stefanie
authors: S
authors: Schulz
authors: Ambika
authors: A
authors: Singh
authors: Mohamed
authors: M
authors: Abdel-Wahab
authors: Klaus
authors: K
authors: Tiroch
authors: Jürgen
authors: J
authors: Pache
authors: Jörg
authors: J
authors: Hausleiter
authors: Robert A
authors: RA
authors: Byrne
authors: Ilka
authors: I
authors: Ott
authors: Tareq
authors: T
authors: Ibrahim
authors: Massimiliano
authors: M
authors: Fusaro
authors: Melchior
authors: M
authors: Seyfarth
authors: Karl-Ludwig
authors: KL
authors: Laugwitz
authors: Steffen
authors: S
authors: Massberg
authors: Adnan
authors: A
authors: Kastrati
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000401:mortality; D023903:Coronary Restenosis / Q000000981:diagnostic imaging; D054855:Drug-Eluting Stents; D000068338:Everolimus; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus; C489443:zotarolimus; D020123:Sirolimus
keywords: CABG; CI; DES; EES; LMCA; MI; PCI; RR; TLR; ZES; aortocoronary artery bypass graft; confidence interval; coronary artery disease; drug-eluting stent(s); everolimus; everolimus-eluting stent(s); left main coronary artery; myocardial infarction; percutaneous coronary intervention; relative risk; restenosis; target lesion revascularization; uLMCA; unprotected left main coronary artery; zotarolimus; zotarolimus-eluting stent(s)