Comparison the long-term clinical outcomes of Nano polymer-free sirolimus-eluting stent versus Endeavor durable polymer zotarolimus-eluting stent in patients with acute coronary syndrome

摘要

Background Durable polymer drug eluting stent(DES) is confronted with many issues, especially the incidence of late stent thrombosis(ST) which is mainly due to delayed healing and re-endothelization by the durable polymer coating. Newer polymer-free DES might have a reduction in late stent thrombosis. Therefore, the aim of this study was to evaluate the efficacy and safety of two different drug eluting stents in patients with acute coronary syndromes(ACS) by one year follow-up. Methods This study assessed the results of the Nano polymerfree SES(Lepu Medical Technology, Beijing, China) and Endeavor durable-polymer ZES(Medtronic, Minneapolis, MN, USA) in ACS patients by clinical follow-up and coronary angiography analysis. The primary endpoint was the onset of any major adverse cardiac events(MACE) such as cardiac death, myocardial infarction(MI) and target vessel revascularization(TVR). The secondary endpoints were target lesion revascularization(TLR) and stent thrombosis(ST) at the end of one year follow-up. Results Between April 2014 and June 2015, a total of513 consecutive patients were enrolled in this trial. There were 259 patients enrolled in Nano group and 253 patients in Endeavor group. Mean age was 62.8 ± 10.3 years old(range: 28 to 87 years of age), and 65.3% of patients were male. Compared Nano-SES to Endeavor-ZES, the incidence of MACE was 5.4% vs. 7.1%. The hazard ratio(HR) was 1.32 with 95% confidence interval(CI) as 0.64-2.72(P = 0.45). Secondary end points showed TLR(1.9% vs. 3.2%; HR, 1.42; 95% CI, 0.45-4.55; P = 0.55) and ST(0.4% vs. 0.8%; HR, 2.03; 95% CI, 0.18-5.37; P = 0.99), in the one-year period of follow-up. Conclusion Within one-year, the Nano polymer-free SES has similar safety and efficacy compared with the Endeavor durable-polymer ZES in the treatment of patients with ACS.