Comparison of 3-year clinical outcomes between resolute™ zotarolimus- and sirolimus-eluting stents for long coronary artery stenosis

Objectives Long-term clinical outcomes were evaluated in long coronary artery stenosis treated with different types of drug-eluting stents. Background Long-term follow-up data to compare clinical outcomes between Resolute™ zotarolimus-eluting stent (R-ZES) versus sirolimus-eluting stent (SES) implantation for long coronary artery stenosis is insufficient. Methods A total of 254 patients (307 lesions) treated with R-ZES and 265 patients (303 lesions) treated with SES for long coronary lesions (total stent length ≥30 mm) were enrolled, and long-term (3 years) clinical outcomes were compared between the 2 groups. Efficacy (target lesion revascularization [TLR]) and safety (the composite occurrence of cardiovascular death, target lesion-related myocardial infarction, or target lesion-related definite stent thrombosis) were assessed. Results The 2 groups had similar baseline characteristics except for the duration of dual antiplatelet therapy (23.4 ± 11.2 months in R-ZES-treated patients vs. 27.4 ± 13.9 months in SES-treated patients, P < 0.001). Total stent length was similar in R-ZES-treated patients (45.0 ± 19.0 mm) and SES-treated patients (45.4 ± 18.6 mm) (P = 0.464). The cumulative TLR rate was 4.6% in R-ZES-treated patients versus 4.6% in SES-treated patients (P = 0.911). For safety parameters, R-ZES-treated patients showed a significantly lower rate of the composite occurrence of cardiovascular death, target lesion-related myocardial infarction, or target lesion-related definite stent thrombosis than SES-treated patients (0.4% vs. 2.4%, P = 0.042). Particularly, the occurrence of target lesion-related definite stent thrombosis was significantly lower in R-ZES-treated patients than in SES-treated patients (0.0% vs. 2.0%, P = 0.028). Conclusions R-ZES stents showed superior long-term safety than SES for treating long coronary lesions, while maintaining a similar clinical efficacy.