Related trials
SPIRIT IV, 2010 - everolimus eluting stent vs paclitaxel eluting stent
RESOLUTE All comers, 2010 - zotarolimus eluting stent vs everolimus eluting stent
SORT-OUT-3, 2010 - zotarolimus eluting stent vs sirolimus eluting stent
GISSOC II, 2010 - sirolimus eluting stent vs bare-metal stent
STICH (ventricular reconstruction), 2009 - CABG+surgical ventricular reconstruction vs CABG
NORDISTEMI, 2009 - thrombolysis + angioplasty vs immediate thrombolysis
ZEST (vs SES), 2009 - zotarolimus eluting stent vs sirolimus eluting stent
Juwana, 2009 - sirolimus eluting stent vs paclitaxel eluting stent
ISAR TEST 2 (vs ZES), 2009 - dual sirolimus, probucol eluting stent vs zotarolimus eluting stent
ZEST (vs PES), 2009 - zotarolimus eluting stent vs paclitaxel eluting stent
BARI 2D, 2009 - CABG or PCI vs medical treatment
DEBATER (SES vs BMS), 2009 - sirolimus eluting stent vs bare-metal stent
SYNTAX, 2009 - paclitaxel eluting stent vs CABG
ISAR-TEST-4 (biodegradable polymer), 2009 - sirolimus biodegradable polymer vs sirolimus eluting stent
PASEO, 2009 - drug-eluting stents vs bare-metal stent
ISAR TEST 2 (vs SES), 2009 - dual sirolimus, probucol eluting stent vs sirolimus eluting stent
ISAR TEST 3 (PF), 2009 - polymer free sirolimus stent vs sirolimus eluting stent
GENIUS-STEMI, 2009 - Genous stent vs bare-metal stent
Thiele, 2009 - sirolimus ES vs MIDCAB
ISAR-LEFT-MAIN, 2009 - sirolimus eluting stent vs paclitaxel eluting stent
TRIANA, 2009 - primary ballon angioplasty vs tenecteplase
ZEST AMI (vs SES), 2009 - zotarolimus eluting stent vs sirolimus eluting stent
ISAR TEST 3 (BP), 2009 - sirolimus biodegradable polymer vs sirolimus eluting stent
ENDEAVOR IV, 2009 - zotarolimus eluting stent vs paclitaxel eluting stent
ZEST AMI (vs PES), 2009 - zotarolimus eluting stent vs paclitaxel eluting stent
See also:
All acute myocardial infarction clinical trials
All coronary artery disease clinical trials
All clinical trials of PCI
All clinical trials of zotarolimus eluting stent
|
|
Treatments
Studied treatment |
zotarolimus-eluting stent (Endeavor)
Endeavor (ABT 578-eluting balloon expandable stent, Medtronic)
|
Control treatment |
sirolimus-eluting stents (Cypher)
|
Concomittant treatment |
Pretreatement with aspirin 300mg and clopidogrel 600 mg. During the procedure: bolus of heparin 100 U/kg, with a repeat bolus of 2,000 U to maintain an activated clotting time 300 seconds.
Aspirin 100 to 200 mg daily given indefinitely and
clopidogrel 75mg daily for 12 months |
Patients
Patients |
Acute Myocardial Infarction Patients (STEMI)requiring primary angioplasty with symptom onset <= 12 hours
|
Inclusion criteria |
chest pain 30 minutes, presentation within 12 hours after onset of symptoms, and ST-segment elevation (1mm in 2 standard leads or 2mm in 2 contiguous precordial leads) |
Exclusion criteria |
Previous administration of fibrinolytic agents; Previously documented left ventricular ejection fraction <30%; Previous MI Concomitant left main disease; cardiogenic shock Estimated life expectancy of <12 months |
Baseline characteristics |
age |
60 y |
diabetes (%) |
26% |
unstable angina (%) |
0% |
LAD (%) |
46.8% |
RCA (%) |
44.5% |
LCx (%) |
8.7% |
lesion length (mm) |
27.15 mm |
reference-vessel diameter |
2.99 mm |
Female (%) |
18% |
bifurcated lesions |
10.3% |
ostial lesion |
8.71% |
STEMI |
100% |
Stable angina |
0% |
multi vessels patients |
45% |
|
Method and design
Randomized effectives |
108 / 110 (studied vs. control) |
Design |
Parallel groups |
Blinding |
open |
Follow-up duration |
1 year (mean) |
Number of centre |
12 |
Geographic area |
Korea |
Hypothesis |
Superiority |
Primary endpoint |
death, MI, or ischemia-driven TVR |
Remarks |
|
Remarks / Comments
Results
Endpoint
Studied treat. n/N
Control treat. n/N
Graph
RR [95% CI]
MACE
12 / 108
10 / 110
classic
1,22 [0,55;2,71]
All cause death
3 / 108
4 / 110
classic
0,76 [0,18;3,33]
MI (fatal and non fatal)
0 / 108
2 / 110
classic
0,11 [0,00;6,99]
target-vessel revascularization
9 / 108
6 / 110
classic
1,53 [0,56;4,15]
Stent thrombosis (any, end of follow up)
0 / 108
4 / 110
classic
0,06 [0,00;3,35]
0
2
1.0
Relative risks
|
Endpoint |
Events (%) |
Relative Risk |
95% CI |
Endpoint definition in the trial |
Ref |
Studied treat. |
Control treat. |
MACE
|
12 / 108 (11,1%) |
10 / 110 (9,1%) |
1,22 |
[0,55;2,71] |
|
0 |
All cause death
|
3 / 108 (2,8%) |
4 / 110 (3,6%) |
0,76 |
[0,18;3,33] |
|
0 |
MI (fatal and non fatal)
|
0 / 108 (0,5%) |
2 / 110 (1,8%) |
0,25 |
[0,01;5,58] |
|
0 |
target-vessel revascularization
|
9 / 108 (8,3%) |
6 / 110 (5,5%) |
1,53 |
[0,56;4,15] |
|
0 |
Stent thrombosis (any, end of follow up)
|
0 / 108 (0,5%) |
4 / 110 (3,6%) |
0,13 |
[0,01;2,38] |
|
0 |
The primary endpoint (if exists) appears in blod characters
|
Reference(s) used for data extraction:
0:
|
Endpoint |
studied treat. |
control treat. |
mean diff |
Absolute risk reduction
|
Endpoint |
Events rate |
Absolute risk reduction (ARR) |
Studied treat. |
Control treat. |
MACE |
11,11% |
9,09% |
2,0%
|
All cause death |
2,78% |
3,64% |
-8,6‰
|
target-vessel revascularization |
8,33% |
5,45% |
2,9%
|
Meta-analysis of all similar trials:
Drug eluting stent in coronary artery disease for acute myocardial infarction
myocardial revascularization in acute myocardial infarction for all type of patients
myocardial revascularization in coronary artery disease for all type of patient
PCI in acute myocardial infarction for all type of patients
Reference(s)
-
Lee CW, Park DW, Lee SH, Kim YH, Hong MK, Kim JJ, Park SW, Yun SC, Seong IW, Lee JH, Lee NH, Cho YH, Cheong SS, Lim DS, Yang JY, Lee SG, Kim KS, Yoon J, Jeong MH, Seung KB, Hong TJ, Park SJ.
Comparison of the efficacy and safety of zotarolimus-, sirolimus-, and paclitaxel-eluting stents in patients with ST-elevation myocardial infarction..
Am J Cardiol 2009;104:1370-6
Pubmed
|
Hubmed
| Fulltext
|