Abstract | BACKGROUND: As a substudy of the large, randomized ZEST (Comparison of the Efficacy and Safety of Zotarolimus-Eluting Stent with Sirolimus-Eluting and PacliTaxel-Eluting Stent for Coronary Lesions) trial comparing first- and second-generation drug-eluting stents, we evaluated intimal hyperplasia (IH) and vascular changes using volumetric intravascular ultrasound analysis. METHODS AND RESULTS: Complete angiographic and volumetric intravascular ultrasound data immediately after stenting and at 9-month follow-up were available in 162 patients with 183 lesions: 61 sirolimus-eluting stents (SES), 64 paclitaxel-eluting stents (PES), and 58 zotarolimus-eluting stents (ZES). External elastic membrane, stent, lumen, and peristent plaque volumes (external elastic membrane minus stent) were normalized by stent length. Percent IH volumes were calculated as [IH volume/ stent volume]×100, %. Reduction of minimal luminal area) was greater in PES than SES (-1.4±1.5 mm(2) versus -0.7±0.9 mm(2), P=0.003), whereas minimal luminal area change in ZES was not significantly different from SES (-1.2±1.0 mm(2) versus -0.7±0.9 mm(2), P=0.055). Percent IH volume was less in SES compared with PES (9.8±6.0% versus 17.5±11.2%, P=0.002) or with ZES (9.8±6.0% versus 18.2±7.6%, P=0.005). Comparing ZES versus PES, there were no significant differences in %IH volume (17.5±11.2% versus 18.2±7.6%, P=0.779) or changes in normalized lumen volume (-1.2±1.3 mm(2) versus -1.1±0.8 mm(2), P=0.452). Late stent malapposition was identified in 8 (13%) SES and 2 (3%) PES but in no ZES (P=0.050). Angiographic restenosis was detected in 6 lesions (3 PES and 3 ZES). CONCLUSIONS: The degree of neointimal growth in ZES was similar to that in PES but less than that in SES. ZES had no late stent malappositions. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00418067.
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Authors | Soo-Jin Kang, Gary S Mintz, Duk-Woo Park, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Ki-Hoon Han, Jae-Joong Kim, Seong-Wook Park, Seung-Jung Park |
Journal | Circulation. Cardiovascular interventions
(Circ Cardiovasc Interv)
Vol. 4
Issue 2
Pg. 139-45
(Apr 01 2011)
ISSN: 1941-7632 [Electronic] United States |
PMID | 21364151
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | © 2011 American Heart Association, Inc. |
Chemical References |
- zotarolimus
- Paclitaxel
- Sirolimus
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Topics |
- Aged
- Angioplasty, Balloon, Coronary
- Coronary Angiography
- Coronary Vessels
(diagnostic imaging, pathology)
- Drug-Eluting Stents
(adverse effects)
- Female
- Humans
- Hyperplasia
- Male
- Middle Aged
- Paclitaxel
(administration & dosage)
- Sirolimus
(administration & dosage, analogs & derivatives)
- Tunica Intima
(pathology)
- Ultrasonography, Interventional
(methods)
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