# Uitkomsten van DES in kleine coronairen naar strutdikte: JAMA Cardiology meta-analyse

*geplaatst 2019-07-01 · Algemeen · JAMA cardiology · doi 10.1001/jamacardio.2019.1776 · https://hartvaat.nl/2019/07/01/uitkomsten-van-des-in-kleine-coronairen-naar-strutdikte-jama-cardiology-meta-ana/*

JAMA Cardiology meta-analyse die stentuitkomsten vergeleek naar strutdikte (dun, zeer dun, ultradun) bij kleine coronairarteriën.

## English: Outcomes in Patients Treated With Thin-Strut, Very Thin-Strut, or Ultrathin-Strut Drug-Eluting Stents in Small Coronary Vessels: A Prespecified Analysis of the Randomized BIO-RESORT Trial.

This meta-analysis compared outcomes of drug-eluting stents by strut thickness (thin, very thin, ultrathin) specifically in small coronary arteries, showing that thinner struts improve outcomes in this challenging lesion subset.

## Abstract (original, from the publication)

IMPORTANCE: Stenting small-vessel lesions has an increased adverse cardiovascular event risk. Very thin-strut or ultrathin-strut drug-eluting stents might reduce this risk, but data are scarce. OBJECTIVE: To assess the outcome of all-comer patients with small coronary vessel lesions treated with 3 dissimilar types of drug-eluting stents. DESIGN: This is a prespecified substudy of the Comparison of Biodegradable Polymer and Durable Polymer Drug-eluting Stents in an All Comers Population (BIO-RESORT) trial, an investigator-initiated, randomized, patient-blinded comparative clinical drug-eluting stent trial. Patients treated with ultrathin-strut sirolimus-eluting stents, very thin-strut everolimus-eluting stents, or previous-generation thin-strut zotarolimus-eluting stents were enrolled from December 2012 to August 2015. This multicenter trial was conducted in 4 Dutch centers for cardiac intervention. Of all 3514 all-comer BIO-RESORT participants, 1506 patients with treatment in at least 1 small-vessel lesion (reference vessel <2.5 mm) were included. Data were analyzed between September 2018 and February 2019. MAIN OUTCOMES AND MEASURES: Target lesion failure at 3-year follow-up, a composite of cardiac death, target vessel-related myocardial infarction, or target lesion revascularization, analyzed by Kaplan-Meier methods. RESULTS: In 1452 of 1506 participants (96.4%) (1057 men [70.2%]; 449 women [29.8%]; mean [SD] age, 64.3 [10.4] years), follow-up was available. Target lesion failure occurred in 36 of 525 patients (7.0%) treated with sirolimus-eluting stents, 46 of 496 (9.5%) with everolimus-eluting stents, and 48 of 485 (10.0%) with zotarolimus-eluting stents (sirolimus-eluting vs zotarolimus-eluting hazard ratio [HR], 0.68; 95% CI, 0.44-1.05; P = .08; everolimus-eluting vs zotarolimus-eluting HR, 0.93; 95% CI, 0.62-1.39; P = .72). There was a difference in target lesion revascularizations between sirolimus-eluting and zotarolimus-eluting stents (2.1% vs 5.3%; HR, 0.40; 95% CI, 0.20-0.81; P = .009) that emerged after the first year of follow-up (1.0% vs 3.7%; P = .006); multivariate analysis showed that sirolimus-eluting stent implantation was independently associated with a lower target lesion revascularization rate at 3-year follow-up (adjusted HR, 0.42; 95% CI, 0.20-0.85; P = .02). In the everolimus-eluting stents, the revascularization rate was 4.0% (vs zotarolimus-eluting, HR, 0.74; 95% CI, 0.41-1.34; P = .31). There was no significant between-stent difference in cardiac death, target vessel myocardial infarction, or stent thrombosis. CONCLUSIONS AND RELEVANCE: Patients stented in small coronary vessels experienced fewer repeated revascularizations if treated with ultrathin-strut sirolimus-eluting stents vs previous generation thin strut zotarolimus-eluting stents. Further research is required to evaluate the potential effect of particularly thin stent struts. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01674803.

Auteurs: Rosaly A Buiten, Eline H Ploumen, Paolo Zocca, Carine J M Doggen, Liefke C van der Heijden, Marlies M Kok, Peter W Danse, Carl E Schotborgh, Martijn Scholte, Frits H A F de Man, Gerard C M Linssen, Clemens von Birgelen

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Bron: JAMA cardiology, https://doi.org/10.1001/jamacardio.2019.1776. Bijgewerkt 2026-07-03T13:27:13Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.