Comparison of zotarolimus-eluting stents with sirolimus- and paclitaxel-eluting stents for coronary revascularization: The ZEST (Comparison of the Efficacy and Safety of Zotarolimus-Eluting Stent with Sirolimus-Eluting and PacliTaxel-Eluting Stent for Coronary Lesions) randomized trial

Duk Woo Park, Young Hak Kim, Sung Cheol Yun, Soo Jin Kang, Seung Whan Lee, Cheol Whan Lee, Seong Wook Park, In Whan Seong, Jae Hwan Lee, Seung Jea Tahk, Myung Ho Jeong, Yangsoo Jang, Sang Sig Cheong, Joo Young Yang, Do Sun Lim, Ki Bae Seung, Jei Keon Chae, Seung Ho Hur, Sang Gon Lee, Junghan YoonNae Hee Lee, Young Jin Choi, Hyun Sook Kim, Kee Sik Kim, Hyo Soo Kim, Taeg Jong Hong, Hun Sik Park, Seung Jung Park

Research output: Contribution to journalArticle

132 Citations (Scopus)

Abstract

Objectives The aim of this study was to evaluate the relative efficacy and safety of zotarolimus-eluting stents (ZES) in comparison with the established and widely used sirolimus- (SES) and paclitaxel-eluting stents (PES) in routine clinical practice. Background Whether ZES might provide similar clinical and angiographic outcomes in a broad spectrum of patients compared with SES or PES is undetermined. Methods We performed a single-blind, multicenter, prospectively randomized trial to compare ZES with SES and PES in 2,645 patients undergoing percutaneous coronary intervention. The primary end point was a composite of major adverse cardiac events (MACE) (death, myocardial infarction, and ischemia-driven target vessel revascularization) at 12 months. A noninferiority comparison (ZES vs. SES) and a superiority comparison (ZES vs. PES) were performed for the primary end point. Results Baseline clinical and angiographic characteristics were similar in the 3 groups. At 12 months, the ZES group showed noninferior rates of MACE compared with the SES group (10.2% vs. 8.3%, p for noninferiority = 0.01, p for superiority = 0.17) and significantly fewer MACE than the PES group (10.2% vs. 14.1%, p for superiority = 0.01). The incidence of death or myocardial infarction was similar among the groups (ZES vs. SES vs. PES, 5.8% vs. 6.9% vs. 7.6%, respectively, p = 0.31). The incidence of stent thrombosis was significantly lower in the SES group (ZES vs. SES vs. PES, 0.7% vs. 0% vs. 0.8%, respectively, p = 0.02). Conclusions In this large-scale, practical randomized trial, the use of ZES resulted in similar rates of MACE compared with SES and in fewer MACE compared with PES at 12 months. (Comparison of the Efficacy and the Safety of Zotarolimus-Eluting Stent Versus Sirolimus-Eluting Stent and PacliTaxel-Eluting Stent for Coronary Lesions; NCT00418067)

Original languageEnglish
Pages (from-to)1187-1195
Number of pages9
JournalJournal of the American College of Cardiology
Volume56
Issue number15
DOIs
Publication statusPublished - 2010 Oct 5

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Park, D. W., Kim, Y. H., Yun, S. C., Kang, S. J., Lee, S. W., Lee, C. W., Park, S. W., Seong, I. W., Lee, J. H., Tahk, S. J., Jeong, M. H., Jang, Y., Cheong, S. S., Yang, J. Y., Lim, D. S., Seung, K. B., Chae, J. K., Hur, S. H., Lee, S. G., ... Park, S. J. (2010). Comparison of zotarolimus-eluting stents with sirolimus- and paclitaxel-eluting stents for coronary revascularization: The ZEST (Comparison of the Efficacy and Safety of Zotarolimus-Eluting Stent with Sirolimus-Eluting and PacliTaxel-Eluting Stent for Coronary Lesions) randomized trial. Journal of the American College of Cardiology, 56(15), 1187-1195. https://doi.org/10.1016/j.jacc.2010.03.086