BIO-RESORT: SES appears to outperform ZES between 1 and 2 years
The rate of target vessel failure did not differ significantly among patients treated with a biodegradable polymer everolimus-eluting stent or sirolimus-eluting stent compared with a durable polymer zotarolimus-eluting stent at 2-year follow-up, according to data from the BIO-RESORT trial.
However, the SES may be associated with a lower risk for repeat revascularization after 1 year, Marlies M. Kok, MD, from the department of cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the Netherlands, and colleagues reported at EuroPCR.
At 2 years, the rates of TVF — defined as cardiac death, target vessel-related MI and target vessel revascularization — were 8.3% for patients who received a durable polymer ZES (Resolute Integrity, Medtronic), 6.8% for those who received a biodegradable polymer EES (Synergy, Boston Scientific) and 6.6% for those who received a biodegradable polymer SES (Orsiro, Biotronik), with no significant differences for those treated with ZES vs. EES (P = .19) or ZES vs. SES (P = .12).
TVF event rates were consistent across subgroups, with the exception of patients treated for bypass grafts, the researchers noted.
Rates of definite or probable stent thrombosis were also not significantly different between groups, occurring in 0.8% of the ZES group vs. 1% of the EES group (P = .65) and 0.6% of the SES group (P = .62).
In landmark analyses, however, patients treated with SES had significantly lower rates of target lesion revascularization (0.6% vs. 1.5%; P = .04) and target lesion failure (1.1% vs. 2.4%; P = .02), compared with ZES, between 1- and 2-year follow-up. SES, compared with ZES, was also associated with lower rates of MACE, defined as a composite of all-cause death, any MI or emergent CABG, or repeat clinically indicated TLR (0.8% vs. 2.2%; P = .01), and the patient-oriented composite endpoint, defined as all-cause death, any MI or any repeat coronary revascularization (3.2% vs. 5.3%; P = .01). However, the difference in TVF rates remained nonsignificant (1.9% vs. 3%; P = .1), the researchers noted.
The multicenter BIO-RESORT trial aimed to compare 2-year outcomes among patients treated with two different thin-strut biodegradable DES with a thin-strut durable polymer DES. A total of 3,514 all-comers who needed PCI were randomly assigned in a 1:1:1 fashion to receive EES, SES or ZES.
“Two years after stenting, the biodegradable polymer EES and SES showed favorable clinical outcomes that were comparable to the reference durable polymer ZES in a broad all-comers population, including many patients with acute coronary syndromes,” the researchers wrote in a simultaneous publication in EuroIntervention. “Long-term follow-up will be of interest, as landmark analyses provided a signal that the use of SES might reduce the risk of repeat revascularization after the first year of follow-up.” – by Melissa Foster
Kok MM, et al. Trial updates – DES trials. Presented at: EuroPCR; May 22-25, 2018; Paris.
Disclosures: The study was funded by Biotronik, Boston Scientific and Medtronic. The authors report no relevant financial disclosures.