Catheterization and Cardiovascular Interventions

Feng Qian*, Ye Zhong, and Edward L. Hannan



Objectives: To evaluate long-term outcomes in patients undergoing either paclitaxel-eluting stents (PES) or endeavor zotarolimus-eluting stents (E-ZES) placement and to assess comparative effectiveness of PES vs. E-ZES in different “off-label” and “high-risk” patient subgroups.
Background: PES and E-ZES are frequently used in percutaneous coronary interventions (PCIs). However, the long-term comparative effectiveness of PES vs. E-ZES in real practice is unknown.
Methods: We created a longitudinal database by linking the New York State (NYS) cardiac registries, the NYS hospital discharge file, the National Death Index, and the U.S. Census file for patients undergoing either PES or E-ZES placement from July 2008 through December 2009. All-cause mortality, acute myocardial infarction (AMI), target lesion PCI (TLPCI), and target vessel coronary artery bypass graft (TVCABG) surgery were compared for 9,264 propensity score matched patients for a 5-year follow-up period using the Kaplan-Meier method with further adjustment using Cox proportional hazards regression.
Results: We did not detect significant differences between E-ZES and PES (reference) in 5-year mortality (adjusted hazard ratio : 1.02, 95% confidence interval : 0.91–1.14), AMI (AHR: 1.05, 95% CI: 0.90–1.22), TLPCI (AHR: 0.99, 95% CI: 0.86–1.13), and TVCABG (AHR, 1.07, 95% CI: 0.84–1.36). For six “off-label” and two “high-risk” subpopulations, we had similar findings for the two stent groups.
Conclusion: NYS observational data suggest that 5-year outcomes are comparable in patients receiving either PES or E-ZES placement, mirroring the findings of recent clinical trials.

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* Denotes CSDA Associates, Affiliates, and Staff