Zotarolimus eluting Resolute Integrity versus Everolimus eluting Xience Xpedition stents in the management of very long (>30 mm) de novo coronary artery stenosis

Abstract Background Procedural and clinical outcomes in patients with very long (>30 mm) coronary lesions who underwent stent-based percutaneous coronary interventions is still unfavorable. Therefore, we compared the relative efficacy and safety of resolute zotarolimus-eluting stents (R-ZES) and Xpedition everolimus-eluting stents (X-EES) for patients with de novo very long coronary lesions. Method This comparative single center, retrospective study, compared long R-ZES and X-EES in consecutive patients admitted with very long (≥30 mm) native ACC/ AHA Type C coronary lesions in 2014. All patients were followed up clinically at 1, 3, 6 and 12 months. In this study, only symptoms driven angiogram was advised. The study end point was to evaluate immediate procedural success and one year rate of target lesion failure (TLF) which is a composite of cardiac death, target lesion myocardial infarction, or target lesion revascularization (TLR). Results Total number of patients enrolled in this study was 185 (R-ZES = 107; E-EES = 78). The baseline characteristics and post procedural success rate were similar between R-ZES and X-EES groups, including the post stenting lesion lengths (36.6 +/− 1.92 mm versus 40.71 ± 6.175 mm, P = 0.09). At 12-month follow-up, there were no significant between-group differences in the rate of adverse clinical events (death, myocardial infarction, stent thrombosis, target-lesion revascularization, and composite outcomes). Procedural success was achieved in 94% in R-ZES group and 93% in X-EES group (P = 0.24). The incidence of TLF was 5% in R-ZES and and 4% in X-EES groups (HR-1.25; 95% CI- 0.86-5.6; P = 0.19). Conclusion Patients with de novo long coronary artery disease, R-ZES implantation showed similar clinical outcome as compared with X-EES implantation.