Review of Registry and Randomised Comparisons of Zotarolimus-eluting and Sirolimus-eluting Coronary Stents in Western Denmark

The safety and efficacy of coronary stents utilised for treatment of ischaemic heart disease have been extensively evaluated. In comparison with bare metal stents, first-generation drug-eluting stents more than halved the need for target lesion revascularisation (TLR). However, the long-term safety has been questioned as the first-generation drug-eluting stents seemed to be associated with a small, but increased, risk of (very) late stent thrombosis. The latter may be related to an inflammatory reaction caused by the polymer used for drug release control. The second-generation zotarolimuseluting Endeavor® stent was believed to represent a safer alternative. We present an overview of our results from a large randomised trial and a large registry, both of which compared clinical outcomes with the Endeavor® and the first-generation sirolimus-eluting Cypher® stent. Both studies indicated that the Endeavor® stent had higher risks of adverse outcomes. We discuss these data in the light of the current available data from other randomised comparisons of these two drug-eluting stents.