Clinical outcomes of the Resolute zotarolimus-eluting stent in patients with in-stent restenosis: 2-year results from a pooled analysis
| Autor: | Gert, Richardt, Matthias, Leschke, Mohamed, Abdel-Wahab, Ralph, Toelg, Mohamed, El-Mawardy, Patrick W, Serruys, Sigmund, Silber, Stephan, Windecker, Jorge A, Belardi, Franz-Josef, Neumann, Petr, Widimsky |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Sirolimus Time Factors Coronary Thrombosis Myocardial Infarction Cardiovascular Agents Drug-Eluting Stents Middle Aged Prosthesis Design Coronary Restenosis Logistic Models Percutaneous Coronary Intervention Treatment Outcome Risk Factors Multivariate Analysis Odds Ratio Humans Female Registries Propensity Score Aged Randomized Controlled Trials as Topic |
| Zdroj: | JACC. Cardiovascular interventions. 6(9) |
| ISSN: | 1876-7605 |
| Popis: | This study sought to assess the clinical safety and effectiveness of the Resolute zotarolimus-eluting stent (R-ZES) in patients with in-stent restenosis (ISR) from 2 large trials.ISR treatment is associated with higher rates of subsequent cardiac events compared with treatment of de novo lesions. Although drug-eluting stents (DES) are an option, second-generation DES are largely untested in the treatment of ISR.A total of 3,489 patients were pooled from the RAC (RESOLUTE All Comers) trial and the RESOLUTE International (RINT) registry. Two-year clinical endpoints included clinically driven target lesion revascularization (TLR), target lesion failure (TLF), cardiac death (CD), target vessel myocardial infarction (TVMI), combined CD or TVMI (CD/TVMI), and Academic Research Consortium definite and probable stent thrombosis (ST).Overall, 281 patients (8.1%) received an R-ZES for ISR. Two-year TLR and TLF rates were significantly higher in ISR patients than in non-ISR patients (TLR: 12.7% vs. 4.3%, p = 0.003; TLF: 17.4% vs. 9.4%, p = 0.007); however, the CD/TVMI rate was not (6.9% vs. 6.1%, p = 0.711). Seven ISR patients had ST. Two-year outcomes by ISR stent type were similar: bare-metal stent (BMS)-ISR TLR was 12.5% and TLF was 17.2%; DES-ISR TLR was 13.0% and TLF was 18.8%. CD/TVMI was 7.3% and 7.2% for BMS-ISR and DES-ISR, respectively.Using R-ZES to treat ISR appears equally safe in BMS-ISR and DES-ISR, with CD/TVMI rates comparable to 2-year outcomes in other clinical trials. Although revascularization rates are still higher in ISR lesions, the R-ZES offers an effective alternative for treatment of BMS-ISR and DES-ISR. (Randomized, Two-Arm, Non-inferiority Study Comparing Endeavor-Resolute Stent With Abbot Xience-V Stent [RESOLUTE-AC]; NCT00617084; and RESOLUTE International Registry: Evaluation of the Resolute Zotarolimus-Eluting Stent System in a 'Real-World' Patient Population [RINT]; NCT00752128). |
| Databáze: | OpenAIRE |
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