Related trials
SORT-OUT-3, 2010 - zotarolimus eluting stent vs sirolimus eluting stent
BASKET-PROVE (EES), 2010 - everolimus eluting stent vs bare-metal stent
BASKET-PROVE (SES), 2010 - sirolimus eluting stent vs bare-metal stent
SPIRIT IV, 2010 - everolimus eluting stent vs paclitaxel eluting stent
RESOLUTE All comers, 2010 - zotarolimus eluting stent vs everolimus eluting stent
GISSOC II, 2010 - sirolimus eluting stent vs bare-metal stent
STICH (ventricular reconstruction), 2009 - CABG+surgical ventricular reconstruction vs CABG
COMPARE, 2009 - everolimus eluting stent vs paclitaxel eluting stent
ZEST (vs SES), 2009 - zotarolimus eluting stent vs sirolimus 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
PASEO, 2009 - drug-eluting stents vs bare-metal stent
SYNTAX, 2009 - paclitaxel eluting stent vs CABG
ISAR-TEST-4 (biodegradable polymer), 2009 - sirolimus biodegradable polymer vs sirolimus eluting 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
ZEST AMI (vs SES), 2009 - zotarolimus eluting stent vs sirolimus eluting stent
DEBATER (SES vs BMS), 2009 - sirolimus eluting stent vs bare-metal 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 coronary artery disease clinical trials
All clinical trials of myocardial revascularization
All clinical trials of zotarolimus eluting stent
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Treatments
Studied treatment |
zotarolimus-eluting stents
|
Control treatment |
paclitaxel-eluting stents
|
Concomittant treatment |
aspirin and clopidogrel prior to the procedure. Aspirin was administered indefinitly and clopidogrel for at least 12 months. Heparin during PCI. Glycoprotein IIb/IIIa inhibitors at discretion
|
Patients
Patients |
Patients with coronary artery disease
|
Exclusion criteria |
severe left ventricular dysfunction (left ventricular ejection fraction <25%); cardiogenic shock; renal insufficiency; liver dysfunction; left main stenosis; in-stent restenosis of a drug-eluting stent; poor life expectancy
|
Baseline characteristics |
age |
62y |
diabetes (%) |
30% |
unstable angina (%) |
55% |
Female (%) |
34% |
bifurcated lesions |
15% |
ostial lesion |
7% |
multi vessels patients |
47% |
No of stent per lesions |
1.2 |
No of lesions per patients |
1.4 |
|
Method and design
Randomized effectives |
883 / 884 (studied vs. control) |
Blinding |
NA |
Follow-up duration |
1 year |
Primary endpoint |
death, myocardial infarction, TLR |
Remarks |
|
Remarks / Comments
Results
Endpoint
Studied treat. n/N
Control treat. n/N
Graph
RR [95% CI]
MACE
89 / 883
126 / 884
0,71 [0,55;0,91]
All cause death
6 / 883
10 / 884
0,60 [0,22;1,65]
MI (fatal and non fatal)
47 / 883
62 / 884
0,76 [0,53;1,10]
target lesion revascularisation
43 / 883
66 / 884
0,65 [0,45;0,95]
Stent thrombosis (any, end of follow up)
4 / 883
6 / 884
classic
0,67 [0,19;2,36]
0
2
1.0
Relative risks
|
Endpoint |
Events (%) |
Relative Risk |
95% CI |
Endpoint definition in the trial |
Ref |
Studied treat. |
Control treat. |
MACE
|
89 / 883 (10,1%) |
126 / 884 (14,3%) |
0,71 |
[0,55;0,91] |
|
|
All cause death
|
6 / 883 (0,7%) |
10 / 884 (1,1%) |
0,60 |
[0,22;1,65] |
|
|
MI (fatal and non fatal)
|
47 / 883 (5,3%) |
62 / 884 (7,0%) |
0,76 |
[0,53;1,10] |
|
|
target lesion revascularisation
|
43 / 883 (4,9%) |
66 / 884 (7,5%) |
0,65 |
[0,45;0,95] |
|
|
Stent thrombosis (any, end of follow up)
|
4 / 883 (0,5%) |
6 / 884 (0,7%) |
0,67 |
[0,19;2,36] |
|
|
The primary endpoint (if exists) appears in blod characters
|
Reference(s) used for data extraction:
|
Endpoint |
studied treat. |
control treat. |
mean diff |
Absolute risk reduction
|
Endpoint |
Events rate |
Absolute risk reduction (ARR) |
Studied treat. |
Control treat. |
MACE |
10,08% |
14,25% |
-41,7‰
|
All cause death |
6,80‰ |
1,13% |
-4,5‰
|
MI (fatal and non fatal) |
5,32% |
7,01% |
-16,9‰
|
target lesion revascularisation |
4,87% |
7,47% |
-26,0‰
|
Stent thrombosis (any, end of follow up) |
4,53‰ |
6,79‰ |
-2,3‰
|
Meta-analysis of all similar trials:
Drug eluting stent in coronary artery disease for all type of patients
Drug eluting stent in coronary artery disease for unparticular patients
myocardial revascularization in coronary artery disease for all type of patient
Reference(s)
-
Seung-Jung Park .
Comparison of Sirolimus and Paclitaxel-Eluting Stents Versus Zotarolimus-Eluting Stents in Real World Practice: The ZEST Randomized Controlled Trial.
ACC.09/i2, Orlando, FL, March 2009
Pubmed
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Hubmed
| Fulltext
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Park DW, Kim YH, Yun SC, Kang SJ, Lee SW, Lee CW, Park SW, Seong IW, Lee JH, Tahk SJ, Jeong MH, Jang Y, Cheong SS, Yang JY, Lim DS, Seung KB, Chae JK, Hur SH, Lee SG, Yoon J, Lee NH, Choi YJ, Kim HS, Kim KS, Kim HS, Hong TJ, Park HS, Park SJ.
Comparison of Zotarolimus-Eluting Stents With Sirolimus- and Paclitaxel-Eluting Stents for Coronary Revascularization The ZEST (Comparison of the Efficacy and Safety of Zotarolimus-Eluting Stent with Sirolimus-Eluting and PacliTaxel-Eluting Stent for Coronary Lesions) Randomized Trial..
J Am Coll Cardiol 2010 Oct 5;56:1187-95
- 10.1016/j.jacc.2010.03.086
Pubmed
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Hubmed
| Fulltext
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