Three contemporary thin‐strut drug‐eluting stents implanted in severely calcified coronary lesions of participants in a randomized all‐comers trial. Issue 5 (1st April 2020)

• Record Type: Journal Article
• Authors: Buiten, Rosaly A.; Ploumen, Eline H.; Zocca, Paolo; Doggen, Carine J. M.; van Houwelingen, K. Gert; Danse, Peter W.; Schotborgh, Carl E.; Stoel, Martin G.; Scholte, Martijn; Linssen, Gerard C. M.; de Man, Frits H. A. F.; von Birgelen, Clemens
• Is Part Of: Catheterization and cardiovascular interventions. Volume 96:Issue 5(2020)
• Page Start: E508
• Page End: E515
• Publication Date: 2020-04-01
• Subjects: calcified stenosis -- clinical trial -- coronary stents -- percutaneous coronary intervention; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.28886
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: 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.