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 Yoon & 8 others Nae 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

129 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

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Sirolimus
Paclitaxel
Stents
Safety
zotarolimus
Myocardial Infarction
Incidence

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Park, Duk Woo ; Kim, Young Hak ; Yun, Sung Cheol ; Kang, Soo Jin ; Lee, Seung Whan ; Lee, Cheol Whan ; Park, Seong Wook ; Seong, In Whan ; Lee, Jae Hwan ; Tahk, Seung Jea ; Jeong, Myung Ho ; Jang, Yangsoo ; Cheong, Sang Sig ; Yang, Joo Young ; Lim, Do Sun ; Seung, Ki Bae ; Chae, Jei Keon ; Hur, Seung Ho ; Lee, Sang Gon ; Yoon, Junghan ; Lee, Nae Hee ; Choi, Young Jin ; Kim, Hyun Sook ; Kim, Kee Sik ; Kim, Hyo Soo ; Hong, Taeg Jong ; Park, Hun Sik ; Park, Seung Jung. / 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. In: Journal of the American College of Cardiology. 2010 ; Vol. 56, No. 15. pp. 1187-1195.
@article{abdb7588c3f54a32bb471bb0ba3d8ede,
title = "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",
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)",
author = "Park, {Duk Woo} and Kim, {Young Hak} and Yun, {Sung Cheol} and Kang, {Soo Jin} and Lee, {Seung Whan} and Lee, {Cheol Whan} and Park, {Seong Wook} and Seong, {In Whan} and Lee, {Jae Hwan} and Tahk, {Seung Jea} and Jeong, {Myung Ho} and Yangsoo Jang and Cheong, {Sang Sig} and Yang, {Joo Young} and Lim, {Do Sun} and Seung, {Ki Bae} and Chae, {Jei Keon} and Hur, {Seung Ho} and Lee, {Sang Gon} and Junghan Yoon and Lee, {Nae Hee} and Choi, {Young Jin} and Kim, {Hyun Sook} and Kim, {Kee Sik} and Kim, {Hyo Soo} and Hong, {Taeg Jong} and Park, {Hun Sik} and Park, {Seung Jung}",
year = "2010",
month = "10",
day = "5",
doi = "10.1016/j.jacc.2010.03.086",
language = "English",
volume = "56",
pages = "1187--1195",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "15",

}

Park, DW, Kim, YH, Yun, SC, Kang, SJ, Lee, SW, Lee, CW, Park, SW, Seong, IW, Lee, JH, Tahk, SJ, Jeong, MH, Jang, Y, Cheong, SS, Yang, JY, Lim, DS, Seung, KB, Chae, JK, Hur, SH, Lee, SG, Yoon, J, Lee, NH, Choi, YJ, Kim, HS, Kim, KS, Kim, HS, Hong, TJ, Park, HS & Park, SJ 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, vol. 56, no. 15, pp. 1187-1195. https://doi.org/10.1016/j.jacc.2010.03.086

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

In: Journal of the American College of Cardiology, Vol. 56, No. 15, 05.10.2010, p. 1187-1195.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of zotarolimus-eluting stents with sirolimus- and paclitaxel-eluting stents for coronary revascularization

T2 - The ZEST (Comparison of the Efficacy and Safety of Zotarolimus-Eluting Stent with Sirolimus-Eluting and PacliTaxel-Eluting Stent for Coronary Lesions) randomized trial

AU - Park, Duk Woo

AU - Kim, Young Hak

AU - Yun, Sung Cheol

AU - Kang, Soo Jin

AU - Lee, Seung Whan

AU - Lee, Cheol Whan

AU - Park, Seong Wook

AU - Seong, In Whan

AU - Lee, Jae Hwan

AU - Tahk, Seung Jea

AU - Jeong, Myung Ho

AU - Jang, Yangsoo

AU - Cheong, Sang Sig

AU - Yang, Joo Young

AU - Lim, Do Sun

AU - Seung, Ki Bae

AU - Chae, Jei Keon

AU - Hur, Seung Ho

AU - Lee, Sang Gon

AU - Yoon, Junghan

AU - Lee, Nae Hee

AU - Choi, Young Jin

AU - Kim, Hyun Sook

AU - Kim, Kee Sik

AU - Kim, Hyo Soo

AU - Hong, Taeg Jong

AU - Park, Hun Sik

AU - Park, Seung Jung

PY - 2010/10/5

Y1 - 2010/10/5

N2 - 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)

AB - 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)

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U2 - 10.1016/j.jacc.2010.03.086

DO - 10.1016/j.jacc.2010.03.086

M3 - Article

VL - 56

SP - 1187

EP - 1195

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 15

ER -