Coronary interventions

Five-year clinical outcomes of zotarolimus-eluting stents in coronary total occlusions

EuroIntervention 2021;16:1326-1332. DOI: 10.4244/EIJ-D-19-00866

Henning Kelbæk
Henning Kelbæk1, MD, DMSc; Robert W. Yeh2, MD; Thomas Engstrøm3, DMSc, MD; Franz-Josef Neumann4, MD; Patrick W. Serruys5,6, MD, PhD; Stephan Windecker7, MD, PhD; Jorge Belardi8, MD; Shubin Qiao9, MD; Bo Xu9, MBBS; Minglei Liu10, PhD; Sigmund Silber11, MD
1. Department of Cardiology, Zealand University Hospital, Roskilde, Denmark; 2. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, MA, USA; 3. Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; 4. Department of Cardiology and Angiology II, University Heart Center, Bad Krozingen, Germany; 5. Imperial College London, London, United Kingdom; 6. Department of Cardiology, National University of Ireland, Galway, Ireland; 7. Department of Interventional Cardiology, Bern University Hospital, Bern, Switzerland; 8. Division of Cardiology, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina; 9. Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China; 10. Coronary and Structural Heart, Medtronic PLC, Santa Rosa, CA, USA; 11. Department of Cardiology, Isar Heart Center, Munich, Germany

Aims: Reports of long-term outcomes of patients treated with drug-eluting stents in total coronary occlusions are limited. We analysed clinical outcomes of patients treated with the zotarolimus-eluting Resolute stent (R-ZES) implanted in coronary total occlusions versus non-occluded lesions.

Methods and results: Patients treated with R-ZES and included in four trials (RESOLUTE All Comers, RESOLUTE International, RESOLUTE China RCT, and RESOLUTE China Registry) were pooled and divided into three groups – patients with chronic total occlusions (CTO), patients with total occlusions that had occurred recently (rec-TO), and patients without total occlusions (non-TO). Clinical outcomes at five years were analysed. Of 5,487 patients treated with R-ZES in these trials, 8.0% had CTOs, 8.5% rec-TOs and 83.5% non-TOs. Patients had a mean age of 62.8 years, approximately 25% were female and 30% were diabetics. TLF was similar in the three groups at five years (TLF was 13.2%, 12.5% and 13.3% in the CTO, rec-TO and non-TO groups, respectively, p=0.96). Stent thrombosis tended to occur more frequently for rec-TO compared to CTO and non-TO patients (2.6% vs 1.2% and 1.3%, respectively, p=0.11).

Conclusions: In this large population of patients who had R-ZES implanted, five-year clinical outcomes were similar whether or not the stents were implanted in total occlusions.

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drug-eluting stentstable anginaacs/nste-acschronic coronary total occlusion
Coronary interventionsCTO
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