Clinical evaluation of the Resolute zotarolimus-eluting coronary stent system in the treatment of de novo lesions in native coronary arteries: the RESOLUTE US clinical trial

J Am Coll Cardiol. 2011 Apr 26;57(17):1778-83. doi: 10.1016/j.jacc.2011.03.005. Epub 2011 Apr 4.

Abstract

Objectives: The RESOLUTE US (R-US) trial is a prospective, observational study designed to evaluate the clinical effectiveness of the Resolute zotarolimus-eluting stent (R-ZES) in a U.S. population.

Background: The R-ZES releases zotarolimus over a 6-month period in order to achieve optimal clinical effectiveness and safety.

Methods: The R-US trial recruited patients with de novo native coronary lesions suitable for 1- or 2-vessel treatment with stents from 2.25 to 4.0 mm in diameter. In the main analysis cohort (2.5- to 3.5-mm stents and single-lesion treatment), the primary endpoint was 12-month target lesion failure (TLF) defined as the composite of cardiac death, myocardial infarction (MI), and clinically-driven target lesion revascularization (TLR), compared with data from Endeavor zotarolimus-eluting stent (E-ZES) trials, adjusting for baseline covariates through propensity scores.

Results: Overall, 1,402 patients were enrolled with a mean reference vessel diameter of 2.59 ± 0.47 mm and diabetes prevalence of 34.4%. In the main analysis cohort, TLF was 3.7% at 12 months compared with historical E-ZES results (TLF = 6.5%). The R-ZES met the 3.3% margin of noninferiority (rate difference = -2.8%, upper 1-sided 95% confidence interval: -1.3%, p < 0.001). The overall TLF rate was 4.7%, and rates of cardiac death, MI, and TLR were 0.7%, 1.4%, and 2.8%, respectively. The 12-month rate of stent thrombosis was 0.1%.

Conclusions: The R-ZES achieved a very low rate of clinical restenosis while maintaining low rates of important clinical safety events such as death, MI, and stent thrombosis at 1-year follow-up. (The Medtronic RESOLUTE US Clinical Trial [R-US]; NCT00726453).

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cohort Studies
  • Coronary Artery Disease / drug therapy*
  • Coronary Artery Disease / epidemiology*
  • Coronary Artery Disease / pathology
  • Coronary Restenosis / epidemiology
  • Coronary Restenosis / pathology
  • Coronary Restenosis / prevention & control
  • Coronary Vessels / drug effects*
  • Coronary Vessels / pathology
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / pathology
  • Drug-Eluting Stents*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Sirolimus / administration & dosage
  • Sirolimus / analogs & derivatives*
  • Treatment Outcome
  • United States / epidemiology

Substances

  • zotarolimus
  • Sirolimus

Associated data

  • ClinicalTrials.gov/NCT00726453