Review of Registry and Randomised Comparisons of Zotarolimus-eluting and Sirolimus-eluting Coronary Stents in Western Denmark

REVIEW, June 2010, VOL I ISSUE II, ISSN 2042-4884
10.5083/ejcm.20424884.06 , Cite or Link Using DOI
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Michael Maeng MD PhD, Anne Kaltoft MD PhD, Hans-Henrik Tilsted MD, Jan Ravkilde MD DMSci, Lisette O Jensen MD PhD DMSci, Per Thayssen MD DMSci, Niels R Holm MD, Evald H Christiansen MD PhD, Lars R Krusell MD, Christian J Terkelsen MD PhD et all

The safety and efficacy of coronary stents utilised for treatment of ischaemic heart disease have been extensively evaluated. In comparison with bare metal stents, first-generation drug-eluting stents more than halved the need for target lesion revascularisation (TLR). However, the long-term safety has been questioned as the first-generation drug-eluting stents seemed to be associated with a small, but increased, risk of (very) late stent thrombosis.

The latter may be related to an inflammatory reaction caused by the polymer used for drug release control. The second-generation zotarolimus-eluting Endeavor® stent was believed to represent a safer alternative. We present an overview of our results from a large randomised trial and a large registry, both of which compared clinical outcomes with the Endeavor® and the first-generation sirolimus-eluting Cypher® stent. Both studies indicated that the Endeavor® stent had higher risks of adverse outcomes. We discuss these data in the light of the current available data from other randomised comparisons of these two drug-eluting stents.