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Differential long-term outcomes of zotarolimus-eluting stents compared with sirolimus-eluting and paclitaxel-eluting stents in diabetic and nondiabetic patients: two-year subgroup analysis of the ZEST randomized trial.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Jang, Sun-Joo Park, Duk Woo Kim, Won Jang Kim, Yong H. Yun, Sung-Cheol Kang, Soo-Jin Lee, S. K. Lee, Cheol Whan Park, Seong-wook Park, Seung Jung |
| Copyright Year | 2013 |
| Abstract | OBJECTIVES To evaluate the differential treatment effects of zotarolimus-eluting stents (ZES), sirolimus-eluting stents (SES), and paclitaxel-eluting stents (PES) according to diabetic status. BACKGROUND Diabetic patients have a higher risk of ischemic complications after stenting than nondiabetic patients. METHODS Using data from the ZEST randomized trial, comparing ZES with SES and PES, we evaluated relative outcomes among stents in diabetic and nondiabetic patients. The primary outcome was a major adverse cardiac event (MACE), defined as a composite of death, myocardial infarction, or ischemia-driven target-vessel revascularization. RESULTS Of the 2,645 patients enrolled in the ZEST trial, 760 (29%) had diabetes mellitus. Baseline clinical and angiographic characteristics were similar in the three stent groups, regardless of diabetic status. In diabetic patients, ZES showed similar rates of MACE as compared to PES (13.8% vs. 15.3%, P = 0.58), but higher rates of MACE than SES (13.8% vs. 7.7%, P = 0.05). In nondiabetic patients, ZES showed similar rates of MACE as compared to SES (10.3% vs. 10.8%, P = 0.72), whereas significantly lower rates of MACE compared to PES (10.3% vs. 15.3%, P = 0.01). In comparing the ZES and SES groups, there was a substantial interaction between diabetic status and stent types on MACE occurrence (Interaction P = 0.07). However, in comparison of ZES and PES, there were no significant interactions between diabetes and stent type on MACE (Interaction P = 0.25). CONCLUSIONS In diabetic patients, SES showed the lowest rate of MACE compared with ZES and PES. But, in nondiabetic patients, SES and ZES showed significantly lower rates of MACE than PES. ZES shows a diabetes-related interaction on MACE compared with SES, but not with PES. |
| Starting Page | 129 |
| Ending Page | 132 |
| Page Count | 4 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://cvrf.org/download/paper/2013_11.pdf |
| PubMed reference number | 22899589v1 |
| Alternate Webpage(s) | https://doi.org/10.1002/ccd.24603 |
| DOI | 10.1002/ccd.24603 |
| Journal | Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions |
| Volume Number | 81 |
| Issue Number | 7 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Blood Vessel Tissue Cessation of life Diabetes Mellitus Drug-Eluting Stents Ischemia Myocardial Infarction Paclitaxel Patients Sirolimus Stent Device Component Stent, device Subgroup A Nepoviruses Volkmann Contracture revascularization zotarolimus |
| Content Type | Text |
| Resource Type | Article |
