A Randomized Comparison of Platinum Chromium-Based Everolimus-Eluting Stents Versus Cobalt Chromium-Based Zotarolimus-Eluting Stents in All-Comers Receiving Percutaneous Coronary Intervention

Abstract

At 1 year, PtCr-EES was noninferior to CoCr-ZES in all-comers receiving PCI. Although LSD was observed only in PtCr-EES, both the stent length ratio and the frequency of LSD were not significantly different between the 2 stent types, and PtCr-EES was not associated with adverse clinical outcomes. (Harmonizing Optimal Strategy for Treatment of Coronary Artery Stenosis-SAfety & EffectiveneSS of Drug-ElUting Stents & Anti-platelet REgimen [HOST-ASSURE]; NCT01267734).

Safety and Efficacy of Resolute Zotarolimus-Eluting Stents Compared With Everolimus-Eluting Stents

“…Ninety-two studies were assessed for eligibility, and 87 records were discarded due to unmet inclusion criteria. Finally, 5 trials [15][16][17][18][19] were entered into this meta-analysis, including a total of 9899 patients (4319 patients randomly allocated to treatment with R-ZES and 5580 patients randomly allocated to treatment with EES). The interobserver agreement for study selection was excellent (κ=0.95).…”

“…All the included studies had a noninferiority design, and 4 trials were multicentre investigations. 15,[17][18][19] Figure 1 summarizes principal characteristics of both study devices. R-ZES (Resolute or Resolute Integrity; Medtronic Cardiovascular, Santa Rosa, CA) was compared with cobalt…”

“…The patients included in the analyzed trials represented patient populations with a wide range of patient and lesion characteristics, including high-risk population as 4 studies 15,16,18,19 -accounting for >90% of the sample size-featuring an all-comer design. Furthermore, 2 trials reported similar outcomes for R-ZES and EES in patients with complex coronary lesions.…”

“…Four trials included all-comers populations, 15,16,18,19 whereas one trial 17 specifically enrolled patients with unprotected left main coronary artery lesions. The rate of patients lost to follow-up ranged from 0 to 2%.…”

“…First, although 4 trials had an all-comer design, 15,16,18,19 there were several differences with respect to inclusion criteria. However, the lack of significant heterogeneity for all the analyzed study end points underlies the consistency of effects across studies.…”