Prospective multicentre clinical performance evaluation of second and third generation zotarolimus-eluting stents to treat patients with bifurcated coronary lesions.
OBJECTIVE
To assess the "real world" clinical outcome of patients with bifurcated lesions undergoing percutaneous coronary intervention with implantation of second and third generations of zotarolimus-eluting stent.


RESULTS
Nine Italian centres participated in a prospective multicentre clinical project evaluating the outcome of patients receiving zotarolimus-eluting Resolute stent and Resolute Integrity stents. Patients with bifurcated lesions entered this evaluation. Clinical characteristics and angiographic and procedural details were prospectively recorded. Clinical outcome was prospectively assessed to evaluate the occurrence of major adverse cardiac events (MACE). A total of 577 patients were enrolled. The target lesion was distal left main in 11.1% and left anterior descending artery in 52.8%, and 30.3% of lesions were Medina 1,1,1. At a mean follow-up time of 27.0 ± 13.5 months, the survival free from MACE was 91.8%. Survival free from MACE was similar in patients grouped according to different bifurcated lesion complexity. On the contrary, patients receiving a single stent had better survival free from MACE as compared with those with double stent (P = 0.005). At multivariable analysis, double stenting (but not bifurcated lesion complexity) was found to be a significant predictor of MACE (hazard ratio, 2.52; 95% confidence interval, 1.28-4.94; P = 0.007). Of note, patients receiving the second stent as a bail-out had worse survival free from MACE compared with those who received it as a planned technique (P = 0.045).


CONCLUSIONS
The treatment of patients with bifurcated lesions with second and third generation zotarolimus-eluting stents is associated with good long-term clinical outcomes. Clinical outcome seems to be independent of lesion complexity, but may be influenced by the stenting technique (single or double stenting as well as elective or bail-out double stenting). © 2015 Wiley Periodicals, Inc.
Cardiovascular Department, Catholic University of Sacred Heart, Rome, Italy.
Francesco
F
Burzotta
Unità Di Cardiologia, Policlinico Casilino, Rome, Italy.
Francesco
F
Summaria
Unità Di Emodinamica E Cardiologia Interventistica, Istituto Scientifico Universitario San Raffaele, Milan, Italy.
Azeem
A
Latib
Unità Operativa Di Cardiologia, Azienda Ospedaliera Morgagni Pierantoni, Forlì, Italy.
Maria
M
De Vita
Unità Operativa Di Cardiologia, Istituto Clinico Humanitas Mater Domini, Castellanza, Italy.
Cecilia
C
Fantoni
S.S.C, Emodinamica, Ente Ospedaliero Ospedali Galliera, Genova, Italy.
Stefano
S
Benedetto
UOC Cardiologia, Presidio Ospedaliero Di Venere, Bari Carbonara, Italy.
Maurizio
M
Turturo
Unità Di Cardiologia, Ospedale Lorenzo Bonomo, Andria, Italy.
Claudio
C
Larosa
Emodinamica E Cardiologia Interventistica, Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy.
Alessandro
A
Manzoli
Cardiovascular Department, Catholic University of Sacred Heart, Rome, Italy.
Carlo
C
Trani
D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000601:surgery; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011446:Prospective Studies; D011474:Prosthesis Design; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000494:pharmacology; D013997:Time Factors; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; C489443:zotarolimus; D020123:Sirolimus
Resolute Integrity stent; Resolute stent; bifurcation lesions; provisional approach