Comparison of vascular response to zotarolimus-eluting stent versus sirolimus-eluting stent: intravascular ultrasound results from ENDEAVOR III.

Abstract

BACKGROUND:

The purpose of this study was to investigate the vascular response of zotarolimus-eluting stent (ZES) and sirolimus-eluting stent (SES) using serial intravascular ultrasound (IVUS).

METHODS:

Data were obtained from the Endeavor Drug-Eluting Coronary Stent System Versus the Center Siromlimus-Eluting Coronary Stent System in De Novo Native Coronary Artery Lesions (ENDEAVOR) III trial, a randomized study comparing ZES and SES for the treatment of de novo native coronary artery lesions. Serial (baseline and 8-month follow-up) IVUS was available in 258 patients (190 ZES, 68 SES).

RESULTS:

At 8 months, ZES had greater percentage of neointimal volume index (ZES 1.1 +/- 0.8 mm3/mm vs SES 0.2 +/- 0.1 mm3/mm, P < .01), resulting in smaller lumen volume index (6.0 +/- 2.0 mm3/mm vs 7.0 +/- 2.1 mm3/mm, P < .05). Zotarolimus-eluting stents showed larger IVUS-detectable neointimal coverage over stent surface (50.2% vs 10.5%, P < .01) and greater mean neointimal thickness (0.19 +/- 0.07 mm vs 0.10 +/- 0.06 mm, P < .01). Zotarolimus-eluting stents had a significantly lower incidence of late-acquired incomplete stent apposition.

CONCLUSIONS:

Zotarolimus-eluting stent is associated with a significantly greater amount of neointimal hyperplasia compared with SES. This amount of hyperplasia in ZES is distributed throughout the stent at 8-month follow-up.

• Authors: Akiyoshi Miyazawa, Junya Ako, Yoichiro Hongo, Seung-Ho Hur, Ichizo Tsujino, Brian K Courtney, Ali H M Hassan, David E Kandzari, Yasuhiro Honda, Peter J Fitzgerald, ENDEAVOR III Investigators
• Journal: American heart journal (Am Heart J) Vol. 155 Issue 1 Pg. 108-13 (Jan 2008) ISSN: 1097-6744 [Electronic] United States
• PMID: 18082499 (Publication Type: Clinical Trial, Phase III, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• zotarolimus
• Sirolimus

Topics

• Aged
• Angioplasty, Balloon, Coronary (instrumentation, methods)
• Coronary Restenosis (prevention & control)
• Coronary Stenosis (diagnostic imaging, therapy)
• Drug-Eluting Stents
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Probability
• Reference Values
• Risk Assessment
• Sensitivity and Specificity
• Single-Blind Method
• Sirolimus (analogs & derivatives, therapeutic use)
• Survival Rate
• Time Factors
• Treatment Outcome
• Tunica Intima (diagnostic imaging, drug effects, pathology)
• Ultrasonography, Interventional
• Vascular Patency (drug effects)