CardioExchange Archive

The Resolute zotarolimus-eluting stent (ZES) is now starting to demonstrate good long-term results. At an interventional featured clinical study session at the ACC in New Orleans and in a simultaneous publication in the Lancet, Sigmund Silber and colleagues presented the 2-year findings of the RESOLUTE All Comers trial comparing the ZES with the Xience V everolimus-eluting stent (EES) in a broadly representative patient population. Previously, the 1-year results had shown that the ZES was noninferior to the EES with respect to the primary endpoint of cardiac death, target vessel MI, and ischemia-driven target lesion revascularization.

More than 2200 patients at 17 centres in Europe and Israel completed the 2-year follow-up. Patient-related events (all deaths,  MIs, and revascularizations) occurred equally in both groups (20.6% of the ZES group and 20·5% of the EES group). Similarly, stent-related events (target lesion failure) occurred in 11·2% of the ZES group and 10·7% of the EES group (p=0·736). Three patients in each group had a stent thrombosis after 1 year.

The investigators point out that “the greater number of patient-related than stent-related events in patients with complex clinical and lesion characteristics emphasises that during long-term follow-up, the optimisation of secondary prevention is at least as important as the selection of which new generation drug-eluting stent to implant in a specific lesion.”

In an accompanying comment, Jens Lassen writes that “the most important take-home message of the 2-years result of the RESOLUTE All Comers trial is that the overall non-inferiority result was preserved even after cessation of dual antiplatelet therapy, and that the low rate of very late stent thrombosis seems to be achieved without a major increase in late target lesion revascularisations.”

For more of our ACC.11 coverage of late-breaking clinical trials, interviews with the authors of the most important research, and blogs from our fellows on the most interesting presentations at the meeting, check out our Coverage Roundup.