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Three contemporary thin‐strut drug‐eluting stents implanted in severely calcified coronary lesions of participants in a randomized all‐comers trial
Author(s) -
Buiten Rosaly A.,
Ploumen Eline H.,
Zocca Paolo,
Doggen Carine J. M.,
Houwelingen K. Gert,
Danse Peter W.,
Schotborgh Carl E.,
Stoel Martin G.,
Scholte Martijn,
Linssen Gerard C. M.,
Man Frits H. A. F.,
Birgelen Clemens
Publication year - 2020
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28886
Subject(s) - medicine , zotarolimus , target lesion , stent , calcification , revascularization , cardiology , clinical endpoint , lesion , post hoc analysis , surgery , randomized controlled trial , drug eluting stent , percutaneous coronary intervention , radiology , restenosis , myocardial infarction
Objective The objective was to assess the 2‐year clinical performance of three drug‐eluting stents in all‐comer patients with severely calcified coronary lesions. Background Severe lesion calcification increases cardiovascular event risk after coronary stenting, but there is a lack of data on the clinical outcome of all‐comers with severely calcified lesions who were treated with more recently introduced drug‐eluting stents. Methods The BIO‐RESORT trial ( clinicaltrials.gov : NCT01674803 ) randomly assigned 3,514 all‐comer patients to biodegradable polymer Synergy everolimus‐eluting stents (EES) or Orsiro sirolimus‐eluting stents (SES), versus durable polymer Resolute Integrity zotarolimus‐eluting stents (ZES). In a post hoc analysis, we assessed 783 patients (22.3%) with at least one severely calcified target lesion. Results At 2‐year follow‐up (available in 99% of patients), the main composite endpoint target vessel failure occurred in 19/252 (7.6%) of the EES and in 33/265 (12.6%) of the ZES‐treated patients ( p = .07). Target vessel failure occurred in 24/266 (9.1%) of the SES‐treated patients (vs. ZES: p = .21). There was a difference in target vessel revascularization, which was required in EES in 6/252 (2.4%) patients and in ZES in 20/265 (7.7%) patients ( p = .01); the target vessel revascularization rate in SES was 9/266 (3.4%, vs. ZES: p = .04). Multivariate analysis showed that implantation of EES, but not SES, was independently associated with lower target vessel revascularization rates than in ZES. Conclusions In BIO‐RESORT participants with severely calcified target lesions, treatment with EES was associated with a lower 2‐year target vessel revascularization rate than treatment with ZES.