Clinical outcomes after zotarolimus and everolimus drug eluting stent implantation in coronary artery bifurcation lesions: insights from the RESOLUTE All Comers Trial

Diletti, Roberto; Garcia-Garcia, Hector M.; Bourantas, Christos V.; van Geuns, Robert Jan; Van Mieghem, Nicolas M.; Vranckx, Pascal; Zhang, Yao-Jun; Farooq, Vasim; Iqbal, Javaid; Wykrzykowska, Joanna J.; de Vries, Ton; Swart, Michael; Teunissen, Yvonne; Negoita, Manuela; van Leeuwen, Frank; Silber, Sigmund; Windecker, Stephan; Serruys, Patrick W. (2013). Clinical outcomes after zotarolimus and everolimus drug eluting stent implantation in coronary artery bifurcation lesions: insights from the RESOLUTE All Comers Trial. Heart, 99(17), pp. 1267-1274. BMJ Publishing Group 10.1136/heartjnl-2013-303778

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OBJECTIVE

We investigated clinical outcomes after treatment of coronary bifurcation lesions with second generation drug eluting stents (DES).

DESIGN

Post hoc analysis of a randomised, multicentre, non-inferiority trial.

SETTING

Multicentre study.

PATIENTS

All comers study with minimal exclusion criteria.

INTERVENTIONS

Patients were treated with either zotarolimus or everolimus eluting stents. The patient population was divided according to treatment of bifurcation or non-bifurcation lesions and clinical outcomes were compared between groups.

MAIN OUTCOMES MEASURES

Clinical outcomes within 2-year follow-up.

RESULTS

A total of 2265 patients were included in the present analysis. Two-year follow-up data were available in 2223 patients: 1838 patients in the non-bifurcation group and 385 patients in the bifurcation group. At 2-year follow-up the bifurcation and the non-bifurcation lesion groups showed no significant differences in terms of cardiac death (2.3 vs 2.1, p=0.273), target lesion failure (9.7% vs 13.8%, p=0.255), major adverse cardiac events (11.5% vs 15.1%, p=0.305), target lesion revascularisation (4.7% vs 6.0%, p=0.569), and definite or probable stent thrombosis (1.6% vs 1.8%, p=0.419).

CONCLUSIONS

The use of second generation DES for the treatment of coronary bifurcation lesions was associated with similar long term mortality and clinical outcomes compared with non-bifurcation lesions.

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