The role of everolimus-eluting and resolute zotarolimus-eluting stents in the treatment of coronary bifurcations

OBJECTIVES: To compare the long-term clinical outcomes of everolimus-eluting (EES) and Resolute zotarolimus-eluting (R-ZES) stents in the treatment of coronary bifurcation lesions. BACKGROUND: Recent studies have suggested that the R-ZES is comparable to the EES in the treatment of de novo coronary artery disease. Available data on how these compare in the treatment of bifurcation lesions are limited. METHODS: We retrospectively analyzed consecutive de novo bifurcation lesions, including left main stem lesions, treated with either EES or R-ZES between October 2006 and October 2011. Study endpoints examined included major adverse cardiac events (MACEs), defined as the composite of all-cause death, myocardial infarction (MI), including periprocedural MI, and target vessel revascularization (TVR). Target lesion revascularization (TLR) per patient and per bifurcation as well as stent thrombosis (ST) were also analyzed. RESULTS: We identified 235 bifurcation lesions treated with either EES (157 lesions in 154 patients) or R-ZES (78 lesions in 73 patients). Baseline clinical and procedural characteristics were broadly similar between the two groups. No significant differences in MACE (14.6% vs 11.5%; P≤.99) or TVR (8.0% vs 7.3%; P≤.45) rates were noted between the two groups at 2-year follow-up. The incidence of ST was low and similar in both groups (0% vs 1.4%). CONCLUSIONS: EES and R-ZES are associated with acceptable and comparable long-term clinical outcomes when used in the treatment of bifurcation lesions. Further evaluation into the role of currently available drug-eluting stents in bifurcation percutaneous coronary intervention is required.