Three contemporary thin-strut drug-eluting stents implanted in severely calcified coronary lesions of participants in a randomized all-comers trial

Rosaly A. Buiten, Eline H. Ploumen, Paolo Zocca, Carine J.M. Doggen, K. Gert van Houwelingen, Peter W. Danse, Carl E. Schotborgh, Martin G. Stoel, Martijn Scholte, Gerard C.M. Linssen, Frits H.A.F. de Man, Clemens von Birgelen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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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 = 0.21). 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.

Original languageEnglish
JournalCatheterization and cardiovascular interventions
Early online date23 Mar 2020
DOIs
Publication statusE-pub ahead of print/First online - 23 Mar 2020

Keywords

  • UT-Hybrid-D
  • clinical trial
  • coronary stents
  • percutaneous coronary intervention
  • calcified stenosis

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