In a nutshell
This study compared the safety and effectiveness of ridaforolimus-eluting stents (RESs) to zotarolimus-eluting stents (ZESs). It was determined that RESs were as safe and effective as ZES.
Some background
Percutaneous coronary intervention (or angioplasty) is a non-surgical procedure where narrow or blocked arteries are widened or unblocked. In some cases a stent is implanted. A stent is a flexible tube that keeps the artery open. Drug-eluting stents also release medication into the body. These drugs prevent cells from gathering inside the stent and blocking it again. Ridaforolimus and zotarolimus are examples of drugs used in these kinds of stents.
RESs are new devices. The safety and effectiveness of RESs have not yet been shown in humans.
Methods & findings
1919 adults who had a stent implanted were included in this study. Half had RESs implanted. The other half had ZESs implanted. They were examined during their hospital stay, 30 days after the procedure, and 12 months after the procedure.
Device success was slightly lower with RESs (98%) than ZESs (99.4%). Device success meant that the artery was kept open to at least 50% of its normal diameter.
Target lesion failure (TLF) was defined as death due to cardiac causes, heart attacks related to the artery where the stent was implanted, or new blood flow to an area of the heart caused by low oxygen levels. TLF occurred in 5.4% of the RES group and 5.4% of the ZES group after 12 months.
A blood clot developed in the stent of 0.4% of the RES group and 0.8% of the ZES group. In the RES group all the clots developed in the first 30 days after the procedure.
85 patients treated with RES and 73 patients treated with ZES were followed up after 13 months with an angiogram. An angiogram is a procedure that uses dyes and x-rays to see how blood flows in the heart. The results of the angiogram were similar in both groups.
At 13 months 55 patients treated with RES and 56 patients treated with ZES also had an intravascular ultrasound (IVUS). IVUS is a scan that can show the structure of blood vessels. No significant differences were seen between the two groups.
The bottom line
The study concluded that RESs are as safe and as effective as ZESs.
The fine print
This study was funded by Medinol Ltd., the manufacturers of RESs.
What’s next?
Discuss the benefits of RESs and other drug-eluting stents with your physician.
Published By :
Circulation
Date :
Aug 09, 2017
