title: Long-term comparative effectiveness of Endeavor zotarolimus-eluting and everolimus-eluting stents in New York.
abstract: BACKGROUND
  Endeavor zotarolimus-eluting stents (E-ZES) and everolimus-eluting stents (EES) as second-generation stents were approved for use in percutaneous coronary interventions (PCIs) in 2008. We aimed to evaluate the long-term outcomes of E-ZES vs. EES using New York State (NYS) cardiac registries and to compare long-term effectiveness of E-ZES vs. EES in six "off-label" and two "high-risk" subgroups.
  
  
  METHODS
  We created a longitudinal database by linking the NYS cardiac registries, the statewide hospital discharge data, the National Death Index, and the U.S. Census file (2010) for patients receiving either E-ZES or EES from July 2008 through December 2010. We examined outcome measures of all-cause mortality, acute myocardial infarction (AMI), target lesion PCI (TLPCI), and target vessel coronary artery bypass graft (TVCABG) surgery for 13,663 propensity score matched pairs in the 6-year follow-up period. We applied Kaplan-Meier methods and Cox proportional hazards regression for further adjustment of propensity-matched pairs.
  
  
  RESULTS
  Compared with patients receiving EES, patients receiving E-ZES had a significantly higher rate of 6-year all-cause mortality (adjusted hazard ratio (AHR): 1.10, 95% confidence interval (CI): 1.04-1.17, P=0.003), AMI (AHR: 1.12, 95% CI: 1.02-1.23, P=0.01), TLPCI (AHR: 1.28, 95% CI: 1.18-1.39, P<0.001), and TVCABG (AHR: 1.47, 95% CI: 1.26-1.71, P<0.001). EES had better or similar long-term outcomes than E-ZES for the subgroups that were examined.
  
  
  CONCLUSIONS
  At 6years, patients receiving EES generally had better or comparable mortality, AMI, TLPCI, and TVCABG outcomes compared with patients receiving E-ZES.
authors.affiliation: School of Public Health, Room 169, One University Place, Rensselaer, USA. Electronic address: fqian@albany.edu.
authors.forename: Feng
authors.initials: F
authors.lastname: Qian
authors.affiliation: School of Public Health, Room 169, One University Place, Rensselaer, USA.
authors.forename: Ye
authors.initials: Y
authors.lastname: Zhong
authors.affiliation: School of Public Health, Room 169, One University Place, Rensselaer, USA.
authors.forename: Edward L
authors.initials: EL
authors.lastname: Hannan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery*; D054855:Drug-Eluting Stents / Q000639:trends*; D000068338:Everolimus / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D062645:Percutaneous Coronary Intervention / Q000401:mortality / Q000639:trends*; D012042:Registries; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000068338:Everolimus; C489443:zotarolimus; D020123:Sirolimus
keywords: Endeavor zotarolimus-eluting stents; Everolimus-eluting stents; Long-term outcomes; Mortality