Comparison of Zotarolimus-Eluting Stents With Sirolimus- and Paclitaxel-Eluting Stents for Coronary Revascularization The ZEST (Comparison of the Efficacy and Safety of Zotarolimus-Eluting Stent with Sirolimus-Eluting and PacliTaxel-Eluting Stent for Coronary Lesions) Randomized Trial

被引：118

作者：

Park, Duk-Woo ^{[1
]}

Kim, Young-Hak ^{[1
]}

Yun, Sung-Cheol ^{[1
,2
]}

Kang, Soo-Jin ^{[1
]}

Lee, Seung-Whan ^{[1
]}

Lee, Cheol-Whan ^{[1
]}

Park, Seong-Wook ^{[1
]}

Seong, In-Whan ^{[4
]}

Lee, Jae-Hwan ^{[4
]}

Tahk, Seung-Jea ^{[3
]}

Jeong, Myung-Ho ^{[5
]}

Jang, Yangsoo ^{[6
]}

Cheong, Sang-Sig ^{[7
]}

Yang, Joo-Young ^{[8
]}

Lim, Do-Sun ^{[9
]}

Seung, Ki-Bae ^{[10
]}

Chae, Jei-Keon ^{[11
]}

Hur, Seung-Ho ^{[12
]}

Lee, Sang-Gon ^{[13
]}

Yoon, Junghan ^{[14
]}

Lee, Nae-Hee ^{[15
]}

Choi, Young-Jin ^{[16
]}

Kim, Hyun-Sook ^{[16
]}

Kim, Kee-Sik ^{[17
]}

Kim, Hyo-Soo ^{[18
]}

Hong, Taeg-Jong ^{[19
]}

Park, Hun-Sik ^{[20
]}

Park, Seung-Jung ^{[1
]}

机构：

[1] Univ Ulsan, Ctr Med Res & Informat, Dept Cardiol, Coll Med,Asan Med Ctr, Seoul 138736, South Korea

[2] Univ Ulsan, Ctr Med Res & Informat, Div Biostat, Coll Med,Asan Med Ctr, Seoul 138736, South Korea

[3] Ajou Univ, Med Ctr, Suwon 441749, South Korea

[4] Chungnam Natl Univ Hosp, Taejon, South Korea

[5] Chonnam Natl Univ Hosp, Kwangju, South Korea

[6] Yonsei Univ, Severance Hosp, Seoul 120749, South Korea

[7] GangNeung Asan Med Ctr, Kangnung, South Korea

[8] NHIC Ilsan Hosp, Ilsan, South Korea

[9] Korea Univ, Coll Med, Seoul 136705, South Korea

[10] Catholic Univ Korea, St Marys Hosp, Seoul, South Korea

[11] Chonbuk Natl Univ Hosp, Jeonju, South Korea

[12] Keimyung Univ, Dongsan Med Ctr, Taegu, South Korea

[13] Ulsan Univ Hosp, Ulsan, South Korea

[14] Yonsei Univ, Wonju Christian Hosp, Wonju, South Korea

[15] Soonchunhyang Univ, Bucheon Hosp, Puchon, South Korea

[16] Hallym Univ, Sacred Heart Hosp, Anyang, South Korea

[17] Daegu Catholic Univ, Med Ctr, Taegu, South Korea

[18] Seoul Natl Univ Hosp, Seoul 110744, South Korea

[19] Pusan Natl Univ Hosp, Pusan, South Korea

[20] Kyung Pook Natl Univ Hosp, Taegu, South Korea

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2010年 / 56卷 / 15期

关键词：

angioplasty; coronary disease; stents; ARTERY-DISEASE; BARE-METAL; RESTENOSIS; THROMBOSIS; ENDEAVOR; POLYMER; IMPLANTATION; METAANALYSIS; OUTCOMES; DEVICES;

D O I：

10.1016/j.jacc.2010.03.086

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives The aim of this study was to evaluate the relative efficacy and safety of zotarolimus-eluting stents (ZES) in comparison with the established and widely used sirolimus-(SES) and paclitaxel-eluting stents (PES) in routine clinical practice. Background Whether ZES might provide similar clinical and angiographic outcomes in a broad spectrum of patients compared with SES or PES is undetermined. Methods We performed a single-blind, multicenter, prospectively randomized trial to compare ZES with SES and PES in 2,645 patients undergoing percutaneous coronary intervention. The primary end point was a composite of major adverse cardiac events (MACE) (death, myocardial infarction, and ischemia-driven target vessel revascularization) at 12 months. A noninferiority comparison (ZES vs. SES) and a superiority comparison (ZES vs. PES) were performed for the primary end point. Results Baseline clinical and angiographic characteristics were similar in the 3 groups. At 12 months, the ZES group showed noninferior rates of MACE compared with the SES group (10.2% vs. 8.3%, p for noninferiority = 0.01, p for superiority = 0.17) and significantly fewer MACE than the PES group (10.2% vs. 14.1%, p for superiority = 0.01). The incidence of death or myocardial infarction was similar among the groups (ZES vs. SES vs. PES, 5.8% vs. 6.9% vs. 7.6%, respectively, p = 0.31). The incidence of stent thrombosis was significantly lower in the SES group (ZES vs. SES vs. PES, 0.7% vs. 0% vs. 0.8%, respectively, p = 0.02). Conclusions In this large-scale, practical randomized trial, the use of ZES resulted in similar rates of MACE compared with SES and in fewer MACE compared with PES at 12 months. (Comparison of the Efficacy and the Safety of Zotarolimus-Eluting Stent Versus Sirolimus-Eluting Stent and PacliTaxel-Eluting Stent for Coronary Lesions; NCT00418067) (J Am Coll Cardiol 2010;56:1187-95) (C) 2010 by the American College of Cardiology Foundation

引用

页码：1187 / 1195

页数：9

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