Clinical Outcomes of the Resolute Zotarolimus-Eluting Stent in Patients With In-Stent Restenosis

被引：19

作者：

Richardt, Gert ^{[1
]}

Leschke, Matthias ^{[2
]}

Abdel-Wahab, Mohamed ^{[1
]}

Toelg, Ralph ^{[1
]}

El-Mawardy, Mohamed ^{[1
]}

Serruys, Patrick W. ^{[3
]}

Silber, Sigmund ^{[4
]}

Windecker, Stephan ^{[5
]}

Belardi, Jorge A. ^{[6
]}

Neumann, Franz-Josef ^{[7
]}

Widimsky, Petr ^{[8
]}

机构：

[1] Segeberger Kliniken GmbH, Herzzentrum, D-23795 Bad Segeberg, Germany

[2] Kliniken Esslingen, Esslingen Am Neckar, Germany

[3] Erasmus MC, Thoraxctr, Rotterdam, Netherlands

[4] Heart Ctr Isar, Munich, Germany

[5] Univ Hosp Bern, Dept Cardiol, CH-3010 Bern, Switzerland

[6] Cardiovasc Inst Buenos Aires, Buenos Aires, DF, Argentina

[7] Heart Ctr Bad Krozingen, Bad Krozingen, Germany

[8] Charles Univ Prague, Cardioctr Kralovske Vinohrady, Prague, Czech Republic

来源：

JACC-CARDIOVASCULAR INTERVENTIONS | 2013年 / 6卷 / 09期

关键词：

clinical outcome; in-stent restenosis; PCI; zotarolimus-eluting stent; BARE-METAL STENTS; TARGET VESSEL REVASCULARIZATION; 2-YEAR FOLLOW-UP; BALLOON ANGIOPLASTY; VASCULAR BRACHYTHERAPY; MULTICENTER; TRIAL; ANGIOGRAPHY; PREDICTORS; LESIONS;

D O I：

10.1016/j.jcin.2013.04.017

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives This study sought to assess the clinical safety and effectiveness of the Resolute zotarolimus-eluting stent (R-ZES) in patients with in-stent restenosis (ISR) from 2 large trials. Background ISR treatment is associated with higher rates of subsequent cardiac events compared with treatment of de novo lesions. Although drug-eluting stents (DES) are an option, second-generation DES are largely untested in the treatment of ISR. Methods A total of 3,489 patients were pooled from the RAC (RESOLUTE All Comers) trial and the RESOLUTE International (RINT) registry. Two-year clinical endpoints included clinically driven target lesion revascularization (TLR), target lesion failure (TLF), cardiac death (CD), target vessel myocardial infarction (TVMI), combined CD or TVMI (CD/TVMI), and Academic Research Consortium definite and probable stent thrombosis (ST). Results Overall, 281 patients (8.1%) received an R-ZES for ISR. Two-year TLR and TLF rates were significantly higher in ISR patients than in non-ISR patients (TLR: 12.7% vs. 4.3%, p 0.003; TLF: 17.4% vs. 9.4%, p = 0.007); however, the CD/TVMI rate was not (6.9% vs. 6.1%, p = 0.711). Seven ISR patients had ST. Two-year outcomes by ISR stent type were similar: bare-metal stent (BMS)-ISR TLR was 12.5% and TLF was 17.2%; DES-ISR TLR was 13.0% and TLF was 18.8%. CD/TVMI was 7.3% and 7.2% for BMS-ISR and DES-ISR, respectively. Conclusions Using R-ZES to treat ISR appears equally safe in BMS-ISR and DES-ISR, with CD/TVMI rates comparable to 2-year outcomes in other clinical trials. Although revascularization rates are still higher in ISR lesions, the R-ZES offers an effective alternative for treatment of BMS-ISR and DES-ISR. (Randomized, Two-Arm, Non-inferiority Study Comparing Endeavor-Resolute Stent With Abbot Xience-V Stent [RESOLUTE-AC]; NCT00617084; and RESOLUTE International Registry: Evaluation of the Resolute Zotarolimus-Eluting Stent System in a 'Real-World' Patient Population [RINT]; NCT00752128) (C) 2013 by the American College of Cardiology Foundation

引用

页码：905 / 913

页数：9

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