5 Year Follow Up Outcome of Zotarolimus Eluting Stent

Original title: The “Final” 5-Year Follow-Up From the ENDEAVOR IV Trial Comparing a Zotarolimus-Eluting Stent With a Paclitaxel-Eluting Stent. ENDEAVOR IV Investigators Reference: Ajay J. Kirtane et al. J Am Coll Cardiol Intv 2013. Article in press.

The ENDEAVOR IV was a randomized controlled study with a noninferiority design that compared the Endeavor zotarolimus eluting stent (Medtronic, Santa Rosa, California) with the Taxus Express paclitaxel eluting stent (Boston Scientific, Natick, Massachusetts) in de novo coronary lesions. This is the study´s final 5 year follow up report.

It included 1548 patients randomized 1:1 to Endeavor or Taxus; at 12 months, the first group presented greater late lumen loss. At 5 years, target vessel revascularization was similar for both stents. (Endeavor 12.7% vs Taxus 15%, p=0.22). Regarding the safety end points, at 5 years a similar death rate was observed in both groups (Endeavor 10% vs Taxus 9.1%, p=0.59). However, the myocardial infarction rate associated to the target vessel in this same period was significantly lower with Endeavor (2.6% vs 6%, p=0.002). Very late definitive/probable thrombosis was also significantly lower with Endeavor (0.4% vs 1.8%, p=0.012). This reduction was observed despite the larger number of patients in the Taxus group, that received double antiaggregation at the end of follow up (41.8% vs 47.9%, p=0.03).

Conclusion: 

This study shows the long term efficacy and safety of the zotarolimus eluting stent Endeavour in treating de novo coronary lesions. A significant reduction in terms of target vessel infarction and stent thrombosis was observed, compared to Taxux, despite the fact that this study should be considered only as a hypothesis generator, due to its limited statistical power.

Editorial Comment: 

A faster drug release of the and greater polymer biocompatibility could explain a faster endotelizacion, and therefore, the lower thrombosis observed with the Endeavor; on the other hand, this same mechanism could also explain the greater late lumen loss observed at a year angiographic follow up. Although it is always important to know the long term results, this study has lost some of its relevance due to the fact that both stents already have newer generations in the market.

SOLACI.ORG

More articles by this author

ACC 2025 | FAME 3: FFR Guided PCI vs CABG 5 Year Outcomes.

Earlier studies comparing percutaneous coronary intervention (PCI) vs coronary artery bypass graft (CABG) have shown fewer events at long term for the surgical strategy.  However,...

CRABBIS Trial: Comparison of Different Provisional Stenting Sequences

Provisional stenting (PS) is the gold standard for percutaneous coronary intervention (PCI) in most patients with coronary bifurcation lesions (CBL). Moreover, recent studies such...

Andromeda Trial: Meta-Analysis of Drug Coated Balloon vs. DES in Small Vessel DeNovo Lesions

The use of coronary stents vs plain old balloon angioplasty (POBA), has allowed to reduce recoil and limiting flow dissection which were major limitation...

QFR vs. FFR: Is Coronary Revascularization Deferral Safe? Results from a FAVOR III Sub-Analysis

In cases of intermediate coronary lesions, functional assessment is recommended to aid the decision-making process regarding revascularization. There are several tools currently used to...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

ACC 2025 | FAME 3: FFR Guided PCI vs CABG 5 Year Outcomes.

Earlier studies comparing percutaneous coronary intervention (PCI) vs coronary artery bypass graft (CABG) have shown fewer events at long term for the surgical strategy.  However,...

ACC 2025 | API-CAT: Reduced vs. Full Dose Extended Anticoagulation in Patients with Cancer Related VTE

The risk of cancer related recurrent venous thromboembolism (VTE) will drop over time, while bleeding risk will persist. At present, it is recommended we...

STRIDE: Semaglutide in Patients with Peripheral Arterial Disease and Type II Diabetes

Peripheral arterial disease (PAD) is a severe complication in patients with type II diabetes, primarily affecting peripheral vessels, especially below-the-knee (BTK) arteries. This condition...