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

AHA 2024 | SUMMIT

It has been previously shown that the pharmacological treatment of obesity (semaglutide) can reduce cardiovascular events in patients with cardiac failure (CF) and preserved...

AHA 2024 – BPROAD

Hypertension (elevated blood pressure, BP) is the most common comorbidity among diabetic patients and has been associated with higher cardiovascular risk, though as a...

Coronary Artery Disease in Aortic Stenosis: CABG + SAVR vs. TAVR + PCI: Data from Spanish Centers

Multiple randomized studies have shown comparable or superior efficacy of transcatheter aortic valve replacement (TAVR) vs. coronary artery bypass graft (CABG).  However, many of...

Evolution of Small Balloon-Expandable Valves

Small aortic rings (20 mm) have posed a significant challenge for both surgery and transcatheter aortic valve implantation (TAVI) due to their association with an...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

TricValve Transcatheter Bicaval Valve System for Severe Tricuspid Insufficiency: Events at One Year

TricValve is the first bicaval valve system to obtain CE-Mark approval. This device heterotopic device eliminates tricuspid insufficiency reflux into the venous system, reducing...

Long Term Results of the International Chimney Registry

The International Chimney Registry was an observational study aimed at assessing the use of chimney stenting during TAVR either to predict or treat coronary...

CANNULATE TAVR extended study: Impact of Commissural and Coronary Alignment in Coronary Cannulation Following TAVR with Evolut Fx

The new valve Evolut FX has shown better commissural alignment vs. its predecessor Evolut Pro+. Prior studies have already shown commissure alignment facilitates post...