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Clinical outcomes after zotarolimus and everolimus drug eluting stent implantation in coronary artery bifurcation lesions: insights from the RESOLUTE All Comers Trial
  1. Roberto Diletti1,
  2. Hector M Garcia-Garcia2,
  3. Christos V Bourantas1,
  4. Robert Jan van Geuns1,
  5. Nicolas M Van Mieghem1,
  6. Pascal Vranckx3,
  7. Yao-Jun Zhang1,
  8. Vasim Farooq1,
  9. Javaid Iqbal1,
  10. Joanna J Wykrzykowska4,
  11. Ton de Vries2,
  12. Michael Swart2,
  13. Yvonne Teunissen2,
  14. Manuela Negoita5,
  15. Frank van Leeuwen5,
  16. Sigmund Silber6,
  17. Stephan Windecker7,
  18. Patrick W Serruys1,
  19. On behalf of RESOLUTE All Comers Investigators
  1. 1Department of Interventional Cardiology Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
  2. 2Cardialysis, Rotterdam, The Netherlands
  3. 3Department of Interventional Cardiology Virga Jesse Ziekenhuis, Hasselt, Belgium
  4. 4Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  5. 5Medtronic, Santa Rosa, California, USA
  6. 6Heart Centre at the Isar, Munich, Germany
  7. 7Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, Bern, Switzerland
  1. Correspondence to Professor Patrick W Serruys, Thoraxcenter, Erasmus MC, 's-Gravendijkwal 230, Rotterdam 3015 CE, The Netherlands; p.w.j.c.serruys{at}erasmusmc.nl

Abstract

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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