Summary: Second-generation drug-eluting stents have shown better results than their predecessors. In this study we compare two second-generation drug stents in patients with unprotected left coronary trunk injuries.
Methods and results: 650 patients with unprotected trunk injury were randomized to either XIENCE V (everolimus eluting) or RESOLUTE (zotarolimus eluting) stents. The primary endpoint was the rate of major cardiac events (MACE, death, MI, or reintervention of the target vessel) at one year follow up, non-inferiority design compared to RESOLUTE stent versus XIENCE V. The considered non inferiority margin was 9%. Approximately 70% of patients were multi-arterial, while 80% had distal trunk injury. A provisional technique was employed with approximately 65% of patients. MACE rate in RESOLUTE group was 17.5% versus 14.3% in the XIENCE group, fulfilling non-inferiority criterion (p = 0.25). The mortality rate was similar for both groups, (5.6%), as well as thrombosis rate and restenosis.
Conclusions: Both second-generation drug stents were equally safe and effective for the treatment of patients with unprotected left coronary trunk injuries. Long term following up could reveal more interesting facts about their performance and the need for prolonged dual antiplatelet therapy.
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Julinda Mehilli.
2012-10-24
Original title: ISAR-LEFT MAIN 2: A Prospective, Randomized Trial of Everolimus-Eluting vs. Zotarolimus-Eluting Stents in Patients with Unprotected Left Main Disease
