Abstract
Objectives This study sought to test whether the newly developed platinum chromium (PtCr)-based everolimus-eluting stent (EES) is noninferior to the cobalt chromium (CoCr)-based zotarolimus-eluting stent (ZES) in all-comers receiving percutaneous coronary intervention (PCI). Background PtCr provides improved radial strength, conformability, and visibility compared with the CoCr alloy, but PtCr-based stents have not been tested in a wide range of patients receiving PCI. Also, recent case series have raised the issue of longitudinal stent deformation (LSD) with newer drug-eluting stents. Methods We randomly assigned 3,755 all-comers receiving PCI to PtCr-EES or CoCr-ZES. The primary outcome was target lesion failure (TLF) at 1-year post-PCI, defined as the composite of cardiac death, nonfatal target vessel-related myocardial infarction, and ischemia-driven target lesion revascularization. Post-hoc angiographic analysis was performed to qualitatively and quantitatively analyze LSD. Results At 1 year, TLF occurred in 2.9% and 2.9% of the population in the PtCr-EES and CoCr-ZES groups, respectively (superiority p = 0.98, noninferiority p = 0.0247). There were no significant differences in the individual components of TLF as well as the patient-oriented clinical outcome. Of 5,010 stents analyzed, LSD occurred in 0.2% and 0% in the PtCr-EES and CoCr-ZES groups, respectively (p = 0.104). There was no significant difference in post-deployment stent length ratio between the 2 stents (p = 0.352). Conclusions At 1 year, PtCr-EES was noninferior to CoCr-ZES in all-comers receiving PCI. Although LSD was observed only in PtCr-EES, both the stent length ratio and the frequency of LSD were not significantly different between the 2 stent types, and PtCr-EES was not associated with adverse clinical outcomes. (Harmonizing Optimal Strategy for Treatment of Coronary Artery Stenosis-SAfety & EffectiveneSS of Drug-ElUting Stents & Anti-platelet REgimen [HOST-ASSURE]; NCT01267734).
| Original language | English |
|---|---|
| Pages (from-to) | 2805-2816 |
| Number of pages | 12 |
| Journal | Journal of the American College of Cardiology |
| Volume | 63 |
| Issue number | 25 PART A |
| DOIs | |
| Publication status | Published - 2014 Jul 1 |
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All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine
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A randomized comparison of platinum chromium-based everolimus-eluting stents versus cobalt chromium-based zotarolimus-eluting stents in all-comers receiving percutaneous coronary intervention : HOST-ASSURE noninferiority trial. / Park, Kyung Woo; Kang, Si Hyuck; Kang, Hyun Jae; Koo, Bon Kwon; Park, Byoung Eun; Cha, Kwang Soo; Rhew, Jay Young; Jeon, Hui Kyoung; Shin, Eun Seok; Oh, Ju Hyeon; Jeong, Myung Ho; Kim, Sanghyun; Hwang, Kyung Kuk; Yoon, Junghan; Lee, Sung Yun; Park, Tae Ho; Moon, Keon Woong; Kwon, Hyuck Moon; Hur, Seung Ho; Ryu, Jae Kean; Lee, Bong Ryul; Park, Yong Whi; Chae, In Ho; Kim, Hyo Soo.
In: Journal of the American College of Cardiology, Vol. 63, No. 25 PART A, 01.07.2014, p. 2805-2816.Research output: Contribution to journal › Article
TY - JOUR
T1 - A randomized comparison of platinum chromium-based everolimus-eluting stents versus cobalt chromium-based zotarolimus-eluting stents in all-comers receiving percutaneous coronary intervention
T2 - HOST-ASSURE noninferiority trial
AU - Park, Kyung Woo
AU - Kang, Si Hyuck
AU - Kang, Hyun Jae
AU - Koo, Bon Kwon
AU - Park, Byoung Eun
AU - Cha, Kwang Soo
AU - Rhew, Jay Young
AU - Jeon, Hui Kyoung
AU - Shin, Eun Seok
AU - Oh, Ju Hyeon
AU - Jeong, Myung Ho
AU - Kim, Sanghyun
AU - Hwang, Kyung Kuk
AU - Yoon, Junghan
AU - Lee, Sung Yun
AU - Park, Tae Ho
AU - Moon, Keon Woong
AU - Kwon, Hyuck Moon
AU - Hur, Seung Ho
AU - Ryu, Jae Kean
AU - Lee, Bong Ryul
AU - Park, Yong Whi
AU - Chae, In Ho
AU - Kim, Hyo Soo
PY - 2014/7/1
Y1 - 2014/7/1
N2 - Objectives This study sought to test whether the newly developed platinum chromium (PtCr)-based everolimus-eluting stent (EES) is noninferior to the cobalt chromium (CoCr)-based zotarolimus-eluting stent (ZES) in all-comers receiving percutaneous coronary intervention (PCI). Background PtCr provides improved radial strength, conformability, and visibility compared with the CoCr alloy, but PtCr-based stents have not been tested in a wide range of patients receiving PCI. Also, recent case series have raised the issue of longitudinal stent deformation (LSD) with newer drug-eluting stents. Methods We randomly assigned 3,755 all-comers receiving PCI to PtCr-EES or CoCr-ZES. The primary outcome was target lesion failure (TLF) at 1-year post-PCI, defined as the composite of cardiac death, nonfatal target vessel-related myocardial infarction, and ischemia-driven target lesion revascularization. Post-hoc angiographic analysis was performed to qualitatively and quantitatively analyze LSD. Results At 1 year, TLF occurred in 2.9% and 2.9% of the population in the PtCr-EES and CoCr-ZES groups, respectively (superiority p = 0.98, noninferiority p = 0.0247). There were no significant differences in the individual components of TLF as well as the patient-oriented clinical outcome. Of 5,010 stents analyzed, LSD occurred in 0.2% and 0% in the PtCr-EES and CoCr-ZES groups, respectively (p = 0.104). There was no significant difference in post-deployment stent length ratio between the 2 stents (p = 0.352). Conclusions At 1 year, PtCr-EES was noninferior to CoCr-ZES in all-comers receiving PCI. Although LSD was observed only in PtCr-EES, both the stent length ratio and the frequency of LSD were not significantly different between the 2 stent types, and PtCr-EES was not associated with adverse clinical outcomes. (Harmonizing Optimal Strategy for Treatment of Coronary Artery Stenosis-SAfety & EffectiveneSS of Drug-ElUting Stents & Anti-platelet REgimen [HOST-ASSURE]; NCT01267734).
AB - Objectives This study sought to test whether the newly developed platinum chromium (PtCr)-based everolimus-eluting stent (EES) is noninferior to the cobalt chromium (CoCr)-based zotarolimus-eluting stent (ZES) in all-comers receiving percutaneous coronary intervention (PCI). Background PtCr provides improved radial strength, conformability, and visibility compared with the CoCr alloy, but PtCr-based stents have not been tested in a wide range of patients receiving PCI. Also, recent case series have raised the issue of longitudinal stent deformation (LSD) with newer drug-eluting stents. Methods We randomly assigned 3,755 all-comers receiving PCI to PtCr-EES or CoCr-ZES. The primary outcome was target lesion failure (TLF) at 1-year post-PCI, defined as the composite of cardiac death, nonfatal target vessel-related myocardial infarction, and ischemia-driven target lesion revascularization. Post-hoc angiographic analysis was performed to qualitatively and quantitatively analyze LSD. Results At 1 year, TLF occurred in 2.9% and 2.9% of the population in the PtCr-EES and CoCr-ZES groups, respectively (superiority p = 0.98, noninferiority p = 0.0247). There were no significant differences in the individual components of TLF as well as the patient-oriented clinical outcome. Of 5,010 stents analyzed, LSD occurred in 0.2% and 0% in the PtCr-EES and CoCr-ZES groups, respectively (p = 0.104). There was no significant difference in post-deployment stent length ratio between the 2 stents (p = 0.352). Conclusions At 1 year, PtCr-EES was noninferior to CoCr-ZES in all-comers receiving PCI. Although LSD was observed only in PtCr-EES, both the stent length ratio and the frequency of LSD were not significantly different between the 2 stent types, and PtCr-EES was not associated with adverse clinical outcomes. (Harmonizing Optimal Strategy for Treatment of Coronary Artery Stenosis-SAfety & EffectiveneSS of Drug-ElUting Stents & Anti-platelet REgimen [HOST-ASSURE]; NCT01267734).
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U2 - 10.1016/j.jacc.2014.04.013
DO - 10.1016/j.jacc.2014.04.013
M3 - Article
VL - 63
SP - 2805
EP - 2816
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 25 PART A
ER -