title: Three-year outcomes of percutaneous coronary intervention with next-generation zotarolimus-eluting stents for de novo coronary bifurcation lesions.
abstract: OBJECTIVE
  To investigate the outcomes of percutaneous coronary intervention (PCI) in bifurcation versus non-bifurcation lesions using the next-generation Resolute zotarolimus-eluting stent (R-ZES).
  
  
  RESULTS
  We analyzed 3-year pooled data from the RESOLUTE All-Comers trial and the RESOLUTE International registry. The R-ZES was used in 2772 non-bifurcation lesion patients and 703 bifurcation lesion patients, of which 482 were treated with a simple-stent technique (1 stent used to treat the bifurcation lesion) and 221 with a complex bifurcation technique (2 or more stents used). The primary endpoint was 3-year target lesion failure (TLF, defined as the composite of death from cardiac causes, target vessel myocardial infarction, or clinically-indicated target lesion revascularization [TLR]), and was 13.3% in bifurcation vs 11.3% in non-bifurcation lesion patients (adjusted P=.06). Landmark analysis revealed that this difference was driven by differences in the first 30 days between bifurcation vs non-bifurcation lesions (TLF, 6.6% vs 2.7%, respectively; adjusted P<.001), which included significant differences in each component of TLF and in-stent thrombosis. Between 31 days and 3 years, TLF, its components, and stent thrombosis did not differ significantly between bifurcation lesions and non-bifurcation lesions (TLF, 7.7% vs 9.0%, respectively; adjusted P=.50).
  
  
  CONCLUSIONS
  The 3-year risk of TLF following PCI with R-ZES in bifurcation lesions was not significantly different from non-bifurcation lesions. However, there was an increased risk associated with bifurcation lesions during the first 30 days; beyond 30 days, bifurcation lesions and non-bifurcation lesions yielded similar 3-year outcomes.
authors.affiliation: Universitäts- Herzzentrum Freiburg, Universitäts-Herzzentrum, Suedring 15, Bad Krozingen, 79189, Germany. Franz-Josef.Neumann@universitaets-herzzentrum.de.
authors.forename: Miroslaw
authors.initials: M
authors.lastname: Ferenc
authors.forename: Ran
authors.initials: R
authors.lastname: Kornowski
authors.forename: Jorge
authors.initials: J
authors.lastname: Belardi
authors.forename: Patrick
authors.initials: P
authors.lastname: Serruys
authors.forename: Sigmund
authors.initials: S
authors.lastname: Silber
authors.forename: Petr
authors.initials: P
authors.lastname: Widimský
authors.forename: Stephan
authors.initials: S
authors.lastname: Windecker
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Neumann
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002423:Cause of Death; D023921:Coronary Stenosis / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality; D009204:Myocardial Revascularization; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D000068338:Everolimus; C489443:zotarolimus; D020123:Sirolimus