Issue: April 2014
February 12, 2014
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RESOLUTE All Comers: ZES, EES yield similar 4-year outcomes

Issue: April 2014
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Similar target lesion failure and cardiac death rates at 4 years were reported in patients treated with either a zotarolimus-eluting or everolimus-eluting stent, according to results of the RESOLUTE All Comers study.

In the randomized trial, researchers investigated the Resolute zotarolimus-eluting stent (ZES, Medtronic) and the Xience V everolimus-eluting stent (EES, Abbott Vascular) to determine 4-year outcomes and predictors of repeat revascularization.

There were 1,140 patients in the ZES group and 1,152 patients in the EES group.

Outcome measures included TLF and stent thrombosis at 4 years.

The 4-year TLF rate was 15.2% in the ZES group and 14.6% in the EES group (P=.68). Cardiac death rates also were similar, with 5.4% occurring in the ZES group and 4.7% occurring in the EES group (P=.44). The investigators reported similar rates of target vessel MI (ZES, 5.3% vs. EES, 5.4%; P=1.00), clinically indicated target lesion revascularization (ZES, 7.0% vs. EES, 6.5%; P=.62) and definite/probable stent thrombosis (ZES, 2.3% vs. EES, 1.6%; P=.23).

Age, insulin-treated diabetes, SYNTAX score, treatment of saphenous vein grafts, ostial lesions and in-stent restenosis independently predicted TLR.

Independent predictors of any revascularization included age, diabetes, previous PCI, STEMI, smaller reference vessel diameter, SYNTAX score and treatment of the left anterior descending artery, right coronary artery, saphenous vein grafts, ostial lesions or in-stent restenosis, according to the results.

“TLR represented less than half of all repeat revascularization procedures,” the investigators concluded, adding that the two stent approaches yielded similar safety and efficacy outcomes. “Patient and lesion-related factors predicting the risk of TLR and any revascularization showed considerable overlap.”

Disclosure: The researchers report financial disclosures with companies including Abbott, Biosensors, Boston Scientific, Cordis, Medtronic, OrbusNeich and St. Jude Medical.