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New DES may have comparable outcomes to non-overlapping stents
Pooled data from the RESOLUTE trial suggest that overlapping newer generation drug-eluting stents are safe and effective and have comparable angiographic and clinical outcomes, including repeat revascularization, to non-overlapping stents.
For the study, researchers derived a propensity score adjustment of the baseline anatomical and clinical characteristics of 5,130 patients to compare clinical outcomes between patients implanted with overlapping DES (Resolute zotarolimus-eluting stent [R-ZES], Medtronic; or R-ZES/other DES) against non-overlapping DES. The pooled data came from five controlled studies of the RESOLUTE Global Clinical Program evaluating the R-ZES. Angiographic outcomes for overlapping R-ZES and everolimus-eluting stents were evaluated in the randomized RESOLUTE All-Comers Trial.
In the RESOLUTE Global Clinical Program, 644 of 5,130 patients (12.6%) underwent overlapping DES implantation, which was associated with an increased frequency of MI and more complex/calcified lesion types at baseline. Adjusted in-hospital, 30-day and 2-year clinical outcomes were not statistically significantly different for comparable cardiac death (at 2 years: overlap, 3% vs. non-overlap, 2.1%; P=.36), MACE (13.3% vs. 10.7%; P=.19), target vessel MI (3.9% vs. 3.4%; P=.40), clinically driven target vessel revascularization (7.7% vs. 6.5%; P=.32), and definite/probable stent thrombosis (1.4% vs. 0.9%; P=.28). The 13-month adjusted angiographic outcomes were comparable between the single or overlapping stent approach.
“Although the possibility of an increased neointimal response at the overlap cannot be excluded in the present study, this was not clinically relevant at up to 2 years’ follow-up,” the researchers wrote.
Disclosure: Farooq reports no relevant financial disclosures.