A Randomized Comparison of Platinum Chromium- Based Everolimus-Eluting Stents Versus Cobalt Chromium-Based ZotarolimusEluting Stents in All- Comers Receiving Percutaneous Coronary Intervention

作者：Park Kyung Woo; Kang Si Hyuck; Kang Hyun Jae; Koo Bon Kwon; Park Byoung Eun; Cha Kwang Soo; Rhew Jay Young; Jeon Hui Kyoung; Shin Eun Seok; Oh Ju Hyeon; Jeong Myung Ho; Kim Sanghyun; Hwang Kyung Kuk; Yoon Jung Han; Lee Sung Yun; Park Tae Ho; Moon Keon Woong; Kwon Hyuck Moon; Hur Seung Ho; Ryu Jae Kean; Lee Bong Ryul; Park Yong Whi; Chae In Ho; Kim Hyo Soo^*

来源：Journal of the American College of Cardiology, 2014, 63(25): 2805-2816.

DOI：10.1016/j.jacc.2014.04.013

• all-comers trial
• clinical outcome
• drug-eluting stent(s)
• percutaneous coronary intervention

Objectives This study sought to test whether the newly developed platinum chromium (PtCr)-based everolimus-eluting stent (EES) is noninferior to the cobalt chromium (CoCr)-based zotarolimus-eluting stent (ZES) in all-comers receiving percutaneous coronary intervention (PCI). Background PtCr provides improved radial strength, conformability, and visibility compared with the CoCr alloy, but PtCr-based stents have not been tested in a wide range of patients receiving PCI. Also, recent case series have raised the issue of longitudinal stent deformation (LSD) with newer drug-eluting stents. %26lt;br%26gt;Methods We randomly assigned 3,755 all-comers receiving PCI to PtCr-EES or CoCr-ZES. The primary outcome was target lesion failure (TLF) at 1-year post-PCI, defined as the composite of cardiac death, nonfatal target vessel-related myocardial infarction, and ischemia-driven target lesion revascularization. Post-hoc angiographic analysis was performed to qualitatively and quantitatively analyze LSD. %26lt;br%26gt;Results At 1 year, TLF occurred in 2.9% and 2.9% of the population in the PtCr-EES and CoCr-ZES groups, respectively (superiority p 0.98, noninferiority p 0.0247). There were no significant differences in the individual components of TLF as well as the patient-oriented clinical outcome. Of 5,010 stents analyzed, LSD occurred in 0.2% and 0% in the PtCr-EES and CoCr-ZES groups, respectively (p 0.104). There was no significant difference in post-deployment stent length ratio between the 2 stents (p 0.352). %26lt;br%26gt;Conclusions At 1 year, PtCr-EES was noninferior to CoCr-ZES in all-comers receiving PCI. Although LSD was observed only in PtCrEES, both the stent length ratio and the frequency of LSD were not significantly different between the 2 stent types, and PtCr-EES was not associated with adverse clinical outcomes. (Ha

• 出版日期2014-7-1