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Zhu Z, Wu Y, Shen Z, Xu Y, Li Y, Wang Y, Su X, Li B, Jiang T, Jiang J, Wang L, He S, Li X, Li H, Liu Y, Zhou Y, Tang Q, Chen Y, Fang W, Jiang L, Lu C, Guo J, Zhang J, Chen S, Xia Y, Zheng H, Wang B, Zhang D, Feng L, Tang L, Xu P, Liu X, Zhang R. Safety and efficacy of zotarolimus-eluting stents in the treatment of diabetic coronary lesions in Chinese patients: The RESOLUTE-DIABETES CHINA Study. J Diabetes 2019; 11:204-213. [PMID: 30070032 DOI: 10.1111/1753-0407.12832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 06/27/2018] [Accepted: 07/10/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The RESOLUTE-DIABETES CHINA study was specifically designed to investigate the safety and efficacy of Resolute zotarolimus-eluting stents (ZES; Medtronic, Santa Rosa, CA, USA) in the treatment of diabetic coronary lesions in the Chinese population. METHODS In all, 945 patients with de novo native coronary lesions and type 2 diabetes mellitus were recruited at 32 cardiac centers across the Chinese mainland and were implanted with Resolute ZES. The primary endpoint was target vessel failure (TVF); secondary endpoints were clinical outcomes, namely all-cause death, stroke, bleeding, target lesion revascularization (TLR), target vessel revascularization (TVR), non-TVR, and stent thrombosis (ST). The follow-up period for all endpoints was 12 months after the procedure. RESULTS In all, 933 patients (98.73%) had clinical follow-up at 12 months. The rate of TVF was 11.60%, whereas the rate of occurrence of secondary endpoints was 5.47%, with four patients (0.43%) having subacute or late ST. There were no significant differences in TVF rates comparing patients with different HbA1c levels or receiving different glucose control treatments (all P > 0.05). Patients with multivessel lesions had higher TVF rates (95% confidence intervals) than those with single-vessel lesions (16.76% [12.10%-22.97%) vs 9.72% [7.79%-12.11%], respectively; P = 0.006). There were no significant differences in TVF rates in patients with or without small vessels, bifurcated lesions, or chronic total occlusions (all P > 0.05). [Correction added on 17 January 2019, after first online publication: in the second sentence of Results section, "TLF" was changed to "TVF".]. CONCLUSIONS Resolute ZES may perform well in the Chinese diabetic population, especially in those with poor glucose control, complex lesions, and certain unfavorable clinical features. Further studies are needed to determine why ZES perform well in this population.
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Affiliation(s)
- Zhengbin Zhu
- Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Cardiology, Cardiovascular Research Institution, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yongjian Wu
- Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - Zhujun Shen
- Department of Cardiology, Peking Union Medical College Hospital, Beijing, China
| | - Yawei Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Shanghai, China
| | - Yigang Li
- Department of Cardiology, Xin Hua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yan Wang
- Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen University, Fuzhou, China
| | - Xi Su
- Department of Cardiology, Wuhan Asia Heart Hospital, Wuhan, China
| | - Bao Li
- Department of Cardiology, Shanxi Cardiovascular Hospital, Xian, China
| | - Tiemin Jiang
- Department of Cardiology, The Affiliated Hospital of Armed Police Logistics College, Tianjin, China
| | - Jinfa Jiang
- Department of Cardiology, Shanghai Tongji Hospital, Shanghai, China
| | - Lefeng Wang
- Department of Cardiology, Beijing Chao-Yang Hospital, Beijing, China
| | - Shenghu He
- Department of Cardiology, Northern Jiangsu People's Hospital, Yangzhou, China
| | - Xueqi Li
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hongwei Li
- Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yin Liu
- Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
| | - Yujie Zhou
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Qiang Tang
- Department of Cardiology, Peking University Shougang Hospital, Beijing, China
| | - Yundai Chen
- Department of Cardiology, Military General Hospital of Beijing PLA, Beijing, China
| | - Weiyi Fang
- Department of Cardiology, Shanghai Chest Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Li Jiang
- Department of Cardiology, Tong Ren Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Chengzhi Lu
- Department of Cardiology, Tianjin First Center Hospital, Tianjin, China
| | - Jincheng Guo
- Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Jianjun Zhang
- Department of Cardiology, Shanghai Pudong New Area Gongli Hospital, Shanghai, China
| | - Shaoliang Chen
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yong Xia
- Department of Cardiology, The Affiiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Hongchao Zheng
- Department of Cardiology, Shanghai Xuhui Central Hospital, Shanghai, China
| | - Bin Wang
- Department of Cardiology, Aerospace Center Hospital, Beijing, China
| | - Daifu Zhang
- Department of Cardiology, Pudong New Area People's Hospital, Shanghai, China
| | - Liuliu Feng
- Department of Cardiology, Shidong Hospital of Shanghai Yangpu District, Shanghai, China
| | - Lijiang Tang
- Department of Cardiology, Zhejiang Hospital, Hangzhou, China
| | - Peng Xu
- Department of Cardiology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Xuebo Liu
- Department of Cardiology, Shanghai East Hospital Affiliated to Tong Ji University School of Medicine, Shanghai, China
| | - Ruiyan Zhang
- Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Cardiology, Cardiovascular Research Institution, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Panoulas VF, Mastoris I, Konstantinou K, Tespili M, Ielasi A. Everolimus-eluting stent platforms in percutaneous coronary intervention: comparative effectiveness and outcomes. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2015; 8:317-29. [PMID: 26244031 PMCID: PMC4521664 DOI: 10.2147/mder.s66360] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Despite the remarkable benefits obtained following the introduction of the first-generation drug-eluting stent (DES), concerns were raised over its long-term safety, particularly with regard to very late (beyond 1 year) stent thrombosis. Newer-generation DESs have been developed to overcome this limitation using novel stent platforms, new drugs, more biocompatible durable polymers, and bioabsorbable polymers or backbones. To date, new-generation DESs have virtually replaced the use of first-generation DESs worldwide. In this review article, we discuss in detail the design, pharmacology, and mechanism of action of the newer-generation permanent and bioresorbable everolimus-eluting platforms. Furthermore, we present and evaluate the current evidence on the performance and safety of these devices compared to those of other available stent platforms.
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Affiliation(s)
| | - Ioannis Mastoris
- Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A Wiener Cardiovascular Institute, The Icahn School of Medicine at Mount Sinai, New York NY, USA
| | - Klio Konstantinou
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Maurizio Tespili
- Cardiology Department, Bolognini Hospital Seriate, Seriate (BG), Italy
| | - Alfonso Ielasi
- Cardiology Department, Bolognini Hospital Seriate, Seriate (BG), Italy
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