Comparison of Novel Zotarolimus-Eluting Cobalt-Chromium Stents and Everolimus-Eluting Platinum-Chromium Stents in Patients of the Randomized DUTCH PEERS Trial Presenting with Acute Myocardial Infarction

Background: Historically bare metal stents were considered standard of care for STsegment elevation acute myocardial infarction (STEMI). There is limited data on STEMI patients treated for primary angioplasty with ResoluteTM zotarolimus-eluting stent (R-ZES) and the everolimus-eluting stent (EES). Methods: The global RESOLUTE program enrolled STEMI patients in 4 trials: RESOLUTE-All Comers (RAC), RESOLUTE International, RESOLUTE China, and RESOLUTE China Registry. The multicenter R-AC trial randomized patients to RZES vs. EES. STEMI was a prespecified subset analysis. Target Lesion Failure (TLF) was defined as a composite of death from cardiac causes (CD), target vessel myocardial infarction (TV-MI), and target lesion revascularization (TLR). Stent thrombosis (ST) was defined as ARC definite/probable ST. Results: Among 7618 patients who received R-ZES in the pooled RESOLUTE clinical program, 854 had STEMI. Mean age was 59 12 years, 81% of patients were men, 23% had diabetes mellitus, and patients had on average 1.4 0.7 lesions treated. The 4-year Kaplan-Meier incidence of TLF was 11.5%, TLR 4.8%, CD/TV-MI 8.2%, CD 5.5%, TV-MI 2.7%, and ST 1.9%. Among the 2292 patients randomized in R-AC, 122 STEMI patients were treated with R-ZES and 158 with EES. There were no significant differences at 5 years in TLF, TLR, CD, TV-MI, or ST, but there was a significant reduction in all cause death / TV-MI with R-ZES (5.1% vs 9.0%, p1⁄40.036) (Table). Conclusions: A pooled analysis of complex STEMI patients treated with R-ZES found R-ZES to be associated with excellent and sustained clinical outcomes. Additionally, long-term outcomes with R-ZES in STEMI patients were numerically lower than or similar to EES; however, R-ZES had a significant reduction in all cause death/ TV-MI as compared to EES at 5 years. Submitted on behalf of the RESOLUTE Global Clinical Program.