The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Five-year clinical outcomes for the Resolute zotarolimus-eluting stent in total coronary occlusions

DOI: 10.4244/EIJ-D-19-00866

1. Department of Cardiology, Zealand University Hospital, Roskilde, Denmark, Denmark
2. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
3. Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Denmark
4. Department of Cardiology and Angiology II, University Heart Center, Bad Krozingen, Germany
5. Thorax Center, Erasmus Medical Center, Rotterdam, The Netherlands
6. Department of Interventional Cardiology, Bern University Hospital, Bern Switzerland
7. Division of Cardiology, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
8. Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
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, California, USA
11. Department of Cardiology, Isar Heart Center, Munich, Germany.
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Aims: Reports of long-term outcomes of patients treated with drug-eluting stents in total coronary occlusions are limited. We analyzed clinical outcomes of patients treated with the zotarolimus-eluting Resolute stent (R-ZES) implanted in total coronary versus non-occluded lesions. 

Methods and results:  Patients treated with R-ZES and included in 4 trials (RESOLUTE All Comers, RESOLUTE International, RESOLUTE China RCT, and RESOLUTE China Registry) were pooled and divided in 3 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 5-years were analyzed.   Of 5,487 patients treated with R-ZES in these trials, 8.0% had CTO’s, 8.5% rec-TO’s and 83.5% non-TO’s. Patients had a mean age of 62.8 years, approximately 25% were female and 30% diabetics. TLF was similar in the 3 groups at 5 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, 5-year clinical outcomes were similar whether or not the stents were implanted in total occlusions.

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