Coronary artery diseaseComparison of the Efficacy and Safety of Zotarolimus-, Sirolimus-, and Paclitaxel-Eluting Stents in Patients With ST-Elevation Myocardial Infarction
Section snippets
Methods
This prospective single-blind, randomized multicenter trial—the Comparison of the Efficacy and Safety of Zotarolimus-Eluting Stent versus Sirolimus-Eluting Stent versus Paclitaxel-Eluting Stent for Acute Myocardial Infarction Patients (ZEST-AMI) trial—was performed at 12 centers in Korea (http://ClinicalTrials.gov, NCT00422565). Patients were eligible for the trial if they had chest pain >30 minutes, presentation within 12 hours after onset of symptoms, and ST-segment elevation (>1 mm in ≥2
Results
From September 2006 to September 2007, 328 patients with STEMI were enrolled and randomized to the ZES (n = 108), SES (n = 110), and PES (n = 110) groups. Baseline patient characteristics were well matched among the 3 groups except age, use of angiotensin-converting enzyme inhibitors, number of stents per lesion, or maximum inflation pressure (Table 1, Table 2). Mean patient age was 59.6 ± 11.2 years; 82.3% of patients were men, and 25.9% had diabetes mellitus. Mean time from onset of symptoms
Discussion
The major findings of this study are as follows: (1) there was no difference in the overall rate of major adverse cardiac events at 12 months among the ZES, SES, and PES groups; (2) there was a nonsignificant trend in favor of ZESs in the rate of stent thrombosis; (3) SESs were associated with lower late loss and restenosis rates compared to ZESs or PESs; and (4) the rate of ischemia-driven target vessel revascularization was the same among the 3 DESs. Our results are thus in agreement with
References (30)
- et al.
Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials
Lancet
(2003) - et al.
Primary stent implantation compared with primary balloon angioplasty for acute myocardial infarction: a meta-analysis of randomized clinical trials
Am J Cardiol
(2001) Off-label use of drug-eluting stents putting it in perspective
J Am Coll Cardiol
(2008)- et al.
Comparison of three-year clinical outcome of sirolimus- and paclitaxel-eluting stents versus bare metal stents in patients with ST-segment elevation myocardial infarction (from the RESEARCH and T-SEARCH registries)
Am J Cardiol
(2007) - et al.
Randomized trial of sirolimus-eluting stent versus bare-metal stent in acute myocardial infarction (SESAMI)
J Am Coll Cardiol
(2007) - et al.
Drug-eluting versus bare-metal stents in the treatment of patients with ST-segment elevation myocardial infarction
JACC Cardiovasc Interv
(2008) - et al.
Meta-analysis of clinical trials on use of drug-eluting stents for treatment of acute myocardial infarction
Am Heart J
(2007) - et al.
Comparison of drug-eluting stents versus bare-metal stents for treating ST-segment elevation myocardial infarction
JACC Cardiovasc Interv
(2008) - et al.
Zotarolimus-eluting stents in patients with native coronary artery disease: clinical and angiographic outcomes in 1,317 patients
Am J Cardiol
(2007) - et al.
Comparison of zotarolimus-eluting and sirolimus-eluting stents in patients with native coronary artery disease: a randomized controlled trial
J Am Coll Cardiol
(2006)
Relationship between angiographic late loss and target lesion revascularization after coronary stent implantation: analysis from the TAXUS-IV trial
J Am Coll Cardiol
Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery
N Engl J Med
Safety and efficacy of sirolimus- and paclitaxel-eluting coronary stents
N Engl J Med
Analysis of 14 trials comparing sirolimus-eluting stents with bare-metal stents
N Engl J Med
Effectiveness and safety of drug-eluting stents in Ontario
N Engl J Med
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2018, American Journal of CardiologyCitation Excerpt :The average follow-up of the included studies was 32 months with an average of 1,160 patients per study, although the range was from 64 patients to 8,432 patients. There were 9 trials with a 3-arm design: the stents belonging to a determinate category were in these cases grouped together.8–16 There was 1 study that included bioresorbable vascular scaffold (BVS) in 1 of the arms,17 and 3 studies with BMS in 1 of the arms14,18,19; BMS and BVS were not included in the analysis.
A mixed treatment comparison for short- and long-term outcomes of bare-metal and drug-eluting coronary stents
2016, International Journal of CardiologySex difference in clinical outcomes after percutaneous coronary intervention in Korean population
2014, American Heart JournalImpact of the angiographic mechanisms underlying periprocedural myocardial infarction after drug-eluting stent implantation
2014, American Journal of Cardiology
This study was supported by grants from the Korea Health 21 R&D Project, Ministry of Health & Welfare, Korea (0412-CR02-0704-0001), the CardioVascular Research Foundation, and Asan Institute for Life Science (#2008-217).