Comparable outcomes amongst three different types of drug-eluting stents in BIO-RESORT Trial

1. At 5 years follow-up, rates of target vessel failure were comparable amongst 3 types of drug-eluting stents (DES), in all-comers and patients with diabetes, including Orsiro sirolimus (SES), Synergy everolimus (EES), and Resolute Integrity zotarolimus (ZES),.

Evidence Rating Level: 1 (Excellent)

There are numerous drug-eluting stents (DES) used to prevent vessel failure after percutaneous coronary intervention (PCI), including Orsiro sirolimus (SES), Synergy everolimus (EES), and Resolute Integrity zotarolimus (ZES) eluting stents. The BIO-RESORT randomized trial based in the Netherlands aimed to compare these 3 DES, and found no difference in safety and efficacy at 1 year amongst all-comers. Currently at 5-years follow-up, this study compared the efficacy of each DES amongst all-comers and amongst patients with diabetes. The efficacy was measured in terms of target vessel failure (TVF) occurrence, including myocardial infarction, revascularization, or cardiac mortality. In total, 3514 all-comers were randomized 1:1:1 to the 3 DES, with 3183 (90.6%) available at 5-year follow-up. The mean (SD) age was 63.9 (10.8) years, with 72.5% male. The study found no significant differences in TVF amongst all-comers, which occurred in 12.7% of SES patients, 11.6% of EES patients, and 14.1% of ZES patients (SES vs ZES: Hazards ratio 0.89, 95% CI 0.71-1.12, p = 0.31; EES vs ZES: HR 0.82, 95% CI 0.65-1.04, p = 0.10). As well, there was no significant difference in incidence of stent thrombosis. Amongst patients with diabetes, there were no significant differences in TVF, which occurred in 19.8% of SES patients, 19.2% of EES patients, and 21.1% of ZES patients (SES vs ZES: HR 0.91, 95% CI 0.59-1.42, p = 0.69; EES vs ZES: HR 0.90, 95% CI 0.58-1.40, p = 0.63). Overall, this study showed comparable efficacy outcomes amongst 3 DES types, in both all-comers and patients with diabetes.

Click to read the study in JAHA

Image: PD

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