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Open Access Research article

Clinical outcomes after treatment of multiple lesions with zotarolimus-eluting versus sirolimus-eluting coronary stents (a SORT OUT III substudy)

Troels Thim17*, Michael Maeng1, Jens Flensted Lassen1, Anne Kaltoft1, Lisette Okkels Jensen2, Jan Ravkilde3, Per Thayssen2, Søren Galatius4, Evald Høj Christiansen1, Thomas Engstrøm5, Morten Madsen6, Leif Thuesen1 and Hans Henrik Tilsted3

Author Affiliations

1 Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

2 Department of Cardiology, Odense University Hospital, Odense, Denmark

3 Department of Cardiology, Aarhus University Hospital Aalborg, Aalborg, Denmark

4 Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark

5 Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark

6 Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark

7 Department of Cardiology, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark

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BMC Cardiovascular Disorders 2012, 12:18  doi:10.1186/1471-2261-12-18

Published: 19 March 2012

Abstract

Background

Data on clinical outcomes among patients treated with the zotarolimus-eluting Endeavor™ stent versus the sirolimus-eluting Cypher™ stent favor the sirolimus-eluting stent. However, a separate comparison of clinical outcome among patients treated for multiple lesions with these stents is lacking. We performed this comparison within the SORT OUT III trial data set.

Methods

Among 2332 patients randomized in SORT OUT III, 695 were treated for multiple lesions with zotarolimus-eluting (n = 350) or sirolimus-eluting (n = 345) stents and followed for 18 months. Major adverse cardiac events (MACE); composite of cardiac death, myocardial infarction, or target vessel revascularization (TVR); was the primary endpoint.

Results

Zotarolimus-eluting compared to sirolimus-eluting stent treatment was associated with increased MACE rate (13.2% vs. 2.6%; hazard ratio 5.29 with 95% confidence interval: 2.59-10.8). All secondary endpoints; all cause death, cardiac death, myocardial infarction, TVR, target lesion revascularization, in-stent restenosis, and definite stent thrombosis; were observed more frequently among zotarolimus-eluting stent treated patients. For all endpoints, hazard ratios were 1.6 to 4.6 times higher than in the overall results of the SORT OUT III trial.

Conclusions

We observed better clinical outcomes among patients treated for multiple lesions with the sirolimus-eluting stent compared to those treated with the zotarolimus-eluting stent.