Long‐term efficacy and safety of zotarolimus‐eluting stent in patients with diabetes mellitus: Pooled 5‐year results from the ENDEAVOR III and IV trials. Issue 7 (4th July 2013)

• Record Type: Journal Article
• Authors: Vardi, Moshe; Burke, David A.; Bangalore, Sripal; Pencina, Michael J.; Mauri, Laura; Kandzari, David E.; Leon, Martin B.; Cutlip, Donald E.
• Is Part Of: Catheterization and cardiovascular interventions. Volume 82:Issue 7(2013:Dec. 01)
• Page Start: 1031
• Page End: 1038
• Publication Date: 2013-07-04
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.25045
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd25045-sec-0001" sec-type="section"> <title>Objective</title> <p>To assess long‐term outcomes of Endeavor Zotarolimus‐eluting stent (E‐ZES) implantation in patients with diabetes mellitus (DM). Background: Patients with DM and coronary artery disease have lower restenosis with drug‐eluting stent (DES) compared with bare‐metal stents. Recent data suggest that the E‐ZES is inferior to other DES in this population.</p> </sec> <sec id="ccd25045-sec-0002" sec-type="section"> <title>Methods</title> <p>Patient‐level data for 601 patients with DM from the ENDEAVOR III and ENDEAVOR IV trials were pooled, of which 337 were treated with E‐ZES and 264 were treated with other DES. The primary outcome was target vessel failure (TVF) in the course of 5 years. Outcomes are reported as rates using Kaplan–Meier (KM) survival method and differences between E‐ZES and other stent types (sirolimus‐eluting stent or paclitaxel‐eluting stent) were compared using the log‐rank statistic. The independent effect of stent type on TVF was assessed using Cox proportional hazards regression.</p> </sec> <sec id="ccd25045-sec-0003" sec-type="section"> <title>Results</title> <p>Baseline characteristics were similar between the groups. Five‐year TVF KM rate estimate was numerically lower for E‐ZES, but the difference did not reach statistical significance (20.2 vs. 26.9%, <italic>P</italic> = 0.065). The 5‐year KM rate estimates of major adverse cardiac events (17.7 vs. 26.6%, <italic>P</italic> = 0.012), death (7.6 vs. 15.0%, <italic>P</italic> = 0.004), and myocardial infarction (1.3 vs. 5.1%, <italic>P</italic> = 0.011) were also lower for E‐ZES versus other DES. Conclusions: Patients with DM implanted with E‐ZES have favorable long‐term outcomes compared to first‐generation DES. Long‐term performance of DES should be assessed routinely and may differ from initial performance. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>