Safety of second-generation drug-eluting stents three years after randomised use in the TWENTE trial

EuroIntervention. 2015 Mar;10(11):1276-9. doi: 10.4244/EIJY14M08_11.

Abstract

Aims: To assess three-year clinical outcome following randomised use of the second-generation Resolute zotarolimus-eluting stent (ZES) and the XIENCE V everolimus-eluting stent (EES). For Resolute ZES and randomised use, outcome data ≥3 years are relatively scarce.

Methods and results: The TWENTE trial examined 1,391 patients with stable angina or non-ST-elevation acute coronary syndromes, of whom 21.6% were diabetics, 70.1% had complex B2 or C lesions and 77.4% had "off-label" indications for DES use. Three-year follow-up data were obtained in 1,381 patients (99.3%; 10 withdrawals). Adverse clinical events were independently adjudicated. The primary endpoint target vessel failure (TVF), a composite of cardiac death, target vessel-related myocardial infarction and clinically indicated target vessel revascularisation, was 12.1% for Resolute ZES and 13.4% for XIENCE V EES (p=0.50). Cardiac death rates were 1.9% vs. 3.5% (p=0.06); the other individual components of TVF also showed no significant between-group differences. The rates of definite-or-probable stent thrombosis (1.4% vs. 1.6%, p=0.82) and very late stent thrombosis (0.6% vs. 0.4%, p=1.0) did not differ between the groups.

Conclusions: Three-year follow-up data of patients included in the randomised TWENTE trial demonstrated similar and sustained safety and efficacy of Resolute ZES and XIENCE V EES.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Coronary Syndrome / drug therapy
  • Acute Coronary Syndrome / surgery*
  • Aged
  • Angina, Stable / drug therapy
  • Angina, Stable / surgery*
  • Antineoplastic Agents / therapeutic use*
  • Cardiovascular Diseases / mortality
  • Coronary Stenosis / drug therapy
  • Coronary Stenosis / surgery*
  • Drug-Eluting Stents*
  • Everolimus / therapeutic use*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Myocardial Infarction / epidemiology
  • Myocardial Revascularization / statistics & numerical data
  • Percutaneous Coronary Intervention / instrumentation
  • Reoperation
  • Sirolimus / analogs & derivatives*
  • Sirolimus / therapeutic use
  • Thrombosis / epidemiology
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Everolimus
  • zotarolimus
  • Sirolimus