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SORT-OUT-3, 2010 - zotarolimus eluting stent vs sirolimus eluting stent

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RESOLUTE All comers, 2010 - zotarolimus eluting stent vs everolimus eluting stent

ISAR-DESIRE-2, 2010 - sirolimus eluting stent vs paclitaxel eluting stent

BASKET-PROVE (EES), 2010 - everolimus eluting stent vs bare-metal stent

GISSOC II, 2010 - sirolimus eluting stent vs bare-metal stent

BASKET-PROVE (SES), 2010 - sirolimus eluting stent vs bare-metal stent

STICH (ventricular reconstruction), 2009 - CABG+surgical ventricular reconstruction vs CABG

ISAR TEST 2 (vs ZES), 2009 - dual sirolimus, probucol eluting stent vs zotarolimus eluting stent

SYNTAX, 2009 - paclitaxel eluting stent vs CABG

ISAR-LEFT-MAIN, 2009 - sirolimus eluting stent vs paclitaxel eluting stent

COMPARE, 2009 - everolimus eluting stent vs paclitaxel eluting stent

ISAR TEST 3 (PF), 2009 - polymer free sirolimus stent vs sirolimus eluting stent

PASEO, 2009 - drug-eluting stents vs bare-metal stent

ZEST AMI (vs PES), 2009 - zotarolimus eluting stent vs paclitaxel eluting stent

ISAR TEST 2 (vs SES), 2009 - dual sirolimus, probucol eluting stent vs sirolimus eluting stent

BARI 2D, 2009 - CABG or PCI vs medical treatment

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ISAR TEST 3 (BP), 2009 - sirolimus biodegradable polymer vs sirolimus eluting stent

ENDEAVOR IV, 2009 - zotarolimus eluting stent vs paclitaxel eluting stent

GENIUS-STEMI, 2009 - Genous stent vs bare-metal stent

ZEST (vs SES), 2009 - zotarolimus eluting stent vs sirolimus eluting stent

ZEST AMI (vs SES), 2009 - zotarolimus eluting stent vs sirolimus eluting stent

Thiele, 2009 - sirolimus ES vs MIDCAB

ZEST (vs PES), 2009 - zotarolimus eluting stent vs paclitaxel eluting stent



See also:

  • All coronary artery disease clinical trials
  • All stable angina clinical trials
  • All clinical trials of myocardial revascularization
  • All clinical trials of zotarolimus eluting stent
  •  

    ZEST (vs SES) study, 2009

    [NCT00418067] Preliminary results download pdf: zotarolimus eluting stent | myocardial revascularization for stable angina

    Treatments

    Studied treatment zotarolimus-eluting stents
    Endeavor
    Control treatment sirolimus-eluting stents
    Cypher
    Concomittant treatment Pre-Procedure: aspirin (>= 100mg), clopidogrel (loading dose) 300 or 600 mg; During Procedure: heparin: IV bolus + boluses to maintain ACT>250s, GP IIb/IIIa inhibitors at physician’s discretion ; After Discharge: aspirin 100-325 mg/day indefinitely, clopidogrel: 75 mg once daily for at least 12 months
    Remarks 3 arms: ZES compared vs SES (Cypher) and PES (Taxus)

    Patients

    Patients Patients with coronary artery disease
    Inclusion criteria significant CAD (>=50% stenosis), amenable to stent-assisted PCI; silent ischemia, stable angina, and ACS (unstable angina, NSTEMI)
    Exclusion criteria severe left ventricular dysfunction (left ventricular ejection fraction <25%); cardiogenic shock; renal insufficiency; liver dysfunction; left main stenosis; in-stent restenosis of a drug-eluting stent; poor life expectancy
    Baseline characteristics
    age 62y 
    diabetes (%) 30% 
    unstable angina (%) 55% 
    LAD (%) 52% 
    RCA (%) 27% 
    LCx (%) 21% 
    lesion length (mm) 27.9 mm 
    Female (%) 34% 
    restenotic lesion 1% 
    totally occluded lesions 6% 
    bifurcated lesions 15% 
    ostial lesion 7% 
    multi vessels patients 47% 
    No of stent per lesions 1.2 
    No of lesions per patients 1.4 

    Method and design

    Randomized effectives 883 / 878 (studied vs. control)
    Design Parallel groups
    Blinding Open
    Follow-up duration 1 year
    Number of centre 19
    Geographic area Korea
    Primary endpoint death, myocardial infarction, TLR
    Remarks clinical follow-up at 12 months; angiographic follow-up at 9 months


    Results

    Endpoint Studied treat.
    n/N
    Control treat.
    n/N
    Graph RR [95% CI]

    MACE

    89 / 883
    73 / 878
    1,21 [0,90;1,63]

    All cause death

    6 / 883
    7 / 878
    classic 0,85 [0,29;2,53]

    MI (fatal and non fatal)

    47 / 883
    55 / 878
    0,85 [0,58;1,24]

    target-vessel revascularization

    89 / 883
    73 / 878
    1,21 [0,90;1,63]

    Stent thrombosis (any, end of follow up)

    4 / 883
    0 / 878
    classic 16,90 [0,30;953,46]
    0 2 1.0

    Relative risks
    Endpoint Events (%) Relative Risk 95% CI Endpoint definition
    in the trial
    Ref
    Studied treat. Control treat.
    MACE 89 / 883 (10,1%) 73 / 878 (8,3%) 1,21 [0,90;1,63]
    All cause death 6 / 883 (0,7%) 7 / 878 (0,8%) 0,85 [0,29;2,53]
    MI (fatal and non fatal) 47 / 883 (5,3%) 55 / 878 (6,3%) 0,85 [0,58;1,24]
    target-vessel revascularization 89 / 883 (10,1%) 73 / 878 (8,3%) 1,21 [0,90;1,63]
    Stent thrombosis (any, end of follow up) 4 / 883 (0,5%) 0 / 878 (0,1%) 7,95 [0,42;150,25]
    The primary endpoint (if exists) appears in blod characters
    Reference(s) used for data extraction:
  • 0:

  • Endpoint studied treat. control treat. mean diff

    Absolute risk reduction
    Endpoint Events rate Absolute risk
    reduction (ARR)
    Studied treat. Control treat.
    MACE 10,08% 8,31% 1,8%
    All cause death 6,80‰ 7,97‰ -1,2‰
    MI (fatal and non fatal) 5,32% 6,26% -9,4‰
    target-vessel revascularization 10,08% 8,31% 1,8%

    Meta-analysis of all similar trials:

    Drug eluting stent in coronary artery disease for all type of patients

    Drug eluting stent in coronary artery disease for unparticular patients

    myocardial revascularization in coronary artery disease for all type of patient

    myocardial revascularization in stable angina for all type of patient



    Reference(s)

    Trials register # NCT00418067
    Study web site link ,
    • Park DW, Kim YH, Yun SC, Kang SJ, Lee SW, Lee CW, Park SW, Seong IW, Lee JH, Tahk SJ, Jeong MH, Jang Y, Cheong SS, Yang JY, Lim DS, Seung KB, Chae JK, Hur SH, Lee SG, Yoon J, Lee NH, Choi YJ, Kim HS, Kim KS, Kim HS, Hong TJ, Park HS, Park SJ. 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.. J Am Coll Cardiol 2010 Oct 5;56:1187-95 - 10.1016/j.jacc.2010.03.086
      Pubmed | Hubmed | Fulltext

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