International Journal of Cardiology

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



Background: Endeavor zotarolimus-eluting stents (E-ZES) and everolimus-eluting stents (EES) as second-generation stents were approved for use in percutaneous coronary interventions (PCIs) in 2008. We aimed to evaluate the long-term outcomes of E-ZES vs. EES using New York State (NYS) cardiac registries and to compare long-term effectiveness of E-ZES vs. EES in six “off-label” and two “high-risk” subgroups.
Methods: We created a longitudinal database by linking the NYS cardiac registries, the statewide hospital discharge data, the National Death Index, and the U.S. Census file (2010) for patients receiving either E-ZES or EES from July 2008 through December 2010. We examined outcome measures of all-cause mortality, acute myocardial infarction (AMI), target lesion PCI (TLPCI), and target vessel coronary artery bypass graft (TVCABG) surgery for 13,663 propensity score matched pairs in the 6-year follow-up period. We applied Kaplan-Meier methods and Cox proportional hazards regression for further adjustment of propensity-matched pairs.
Results: Compared with patients receiving EES, patients receiving E-ZES had a significantly higher rate of 6-year all-cause mortality (adjusted hazard ratio (AHR): 1.10, 95% confidence interval (CI): 1.04–1.17, P = 0.003), AMI (AHR: 1.12, 95% CI: 1.02–1.23, P = 0.01), TLPCI (AHR: 1.28, 95% CI: 1.18–1.39, P < 0.001), and TVCABG (AHR: 1.47, 95% CI: 1.26–1.71, P < 0.001). EES had better or similar long-term outcomes than E-ZES for the subgroups that were examined.
Conclusion: At 6 years, patients receiving EES generally had better or comparable mortality, AMI, TLPCI, and TVCABG outcomes compared with patients receiving E-ZES.

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* Denotes CSDA Associates, Affiliates, and Staff