Unrestricted use of endeavor resolute zotarolimus-eluting stent in daily clinical practice: a prospective registry

J Invasive Cardiol. 2012 Jun;24(6):251-5.

Abstract

Background: To evaluate the safety and efficacy of unrestricted Endeavor Resolute zotarolimus-eluting stent (ZES) use. Furthermore, we sought to evaluate clinical outcomes associated with on- and off-label use of Resolute ZES.

Methods: The current study was a prospective, single-center registry. The primary endpoint was major adverse cardiac events (MACE), defined as the composite of death, myocardial infarction (MI), and target-vessel revascularization (TVR). Secondary endpoints were death, MI, TVR, and stent thrombosis (ST).

Results: A total of 370 patients were prospectively enrolled. Off-label Resolute ZES use was performed in 311 patients (84%). At a mean follow-up of 17.3 ± 6 months, MACE occurred in 31 patients (8.5%), death in 15 (4.1%), MI in 10 (2.7%), and TVR in 19 (5.2%). Definite, probable, and possible ST occurred in 9 patients (2.5%). Off-label Resolute ZES implantation, as compared to on-label use, was not associated with an increased risk of MACE (9.4% vs 3.4%; P=.13), death (4.9% vs 0%; P=.14), MI (3.3% vs 0%; P=.38), and TVR (5.5% vs 3.4%; P=.75). On multivariable analysis, previous revascularization (P=.008), but not off-label Resolute ZES implantation (P=.07), was associated with MACE.

Conclusions: In daily clinical practice, Resolute ZES was mostly implanted in patients with off-label indications and associated with a relatively low rate of MACE and TVR.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Angioplasty, Balloon, Coronary / adverse effects
  • Angioplasty, Balloon, Coronary / methods*
  • Angioplasty, Balloon, Coronary / mortality
  • Cohort Studies
  • Coronary Angiography
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / therapy*
  • Coronary Restenosis / diagnostic imaging
  • Coronary Restenosis / epidemiology
  • Drug-Eluting Stents*
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Off-Label Use
  • Prospective Studies
  • Prosthesis Failure
  • Registries
  • Risk Assessment
  • Sirolimus / analogs & derivatives*
  • Sirolimus / pharmacology
  • Statistics, Nonparametric
  • Survival Rate
  • Treatment Outcome

Substances

  • zotarolimus
  • Sirolimus