Comparison of the Efficacy and Safety of Zotarolimus-, Sirolimus-, and Paclitaxel-Eluting Stents in Patients With ST-Elevation Myocardial Infarction

Cheol Whan Lee, Duk Woo Park, Seung Hwan Lee, Young Hak Kim, Myeong Ki Hong, Jae Joong Kim, Seong Wook Park, Sung Cheol Yun, In Whan Seong, Jae Hwan Lee, Nae Hee Lee, Yoon Haeng Cho, Sang Sig Cheong, Do Sun Lim, Joo Young Yang, Sang Gon Lee, Kee Sik Kim, Junghan Yoon, Myung Ho Jeong, Ki Bae SeungTaeg Jong Hong, Seung Jung Park

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Abstract

Drug-eluting stents (DESs) are increasingly used for treatment of acute ST-segment elevation myocardial infarction (STEMI), but there are few comparisons of outcomes of various types of DES. We compared the efficacy and safety of zotarolimus-eluting stents (ZESs), sirolimus-eluting stents (SESs), and paclitaxel-eluting stents (PESs) in primary intervention for STEMI. This multicenter, prospectively randomized ZEST-AMI trial included 328 patients at 12 medical centers who were randomly assigned to ZES (n = 108), SES (n = 110), or PES (n = 110) deployment. The primary end point was major adverse cardiac events (death, MI, and ischemia-driven target vessel revascularization) at 12 months. Secondary end points included the individual components of the primary end point, late loss, angiographic restenosis, and stent thrombosis. Baseline clinical and angiographic characteristics were well matched. In-segment late loss (0.28 ± 0.42 vs 0.46 ± 0.48 vs 0.47 ± 0.50 mm, respectively, p = 0.029) and restenosis rate (2.7% vs 15.9% vs 12.3%, respectively, p = 0.027) at 8 months were lowest in the SES group compared to the ZES and PES groups. At 12 months, cumulative incidence rates of primary end points in the ZES, SES, and PES groups were 11.3%, 8.2%, and 8.2%, respectively (p = 0.834). There were 2 acute (in the SES group) and 5 subacute (2 in the SES group and 3 in the PES group) stent thromboses. Incidence of death, recurrent MI, or ischemia-driven target vessel revascularization did not differ among the 3 groups. In conclusion, despite the difference in restenosis rate, the efficacy and safety of the 3 different DESs showed similar, acceptable results in the treatment of STEMI.

Original languageEnglish
Pages (from-to)1370-1376
Number of pages7
JournalAmerican Journal of Cardiology
Volume104
Issue number10
DOIs
Publication statusPublished - 2009 Nov 15

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Lee, C. W., Park, D. W., Lee, S. H., Kim, Y. H., Hong, M. K., Kim, J. J., Park, S. W., Yun, S. C., Seong, I. W., Lee, J. H., Lee, N. H., Cho, Y. H., Cheong, S. S., Lim, D. S., Yang, J. Y., Lee, S. G., Kim, K. S., Yoon, J., Jeong, M. H., ... Park, S. J. (2009). Comparison of the Efficacy and Safety of Zotarolimus-, Sirolimus-, and Paclitaxel-Eluting Stents in Patients With ST-Elevation Myocardial Infarction. American Journal of Cardiology, 104(10), 1370-1376. https://doi.org/10.1016/j.amjcard.2009.06.059