Six-month IVUS and two-year clinical outcomes in the EVOLVE FHU trial: a randomised evaluation of a novel bioabsorbable polymer-coated, everolimus-eluting stent. - 2013

AIMS: The EVOLVE FHU trial demonstrated non-inferiority of six-month late loss with two dose formulations of SYNERGY, a novel bioabsorbable polymer everolimus-eluting stent (EES) compared with the durable polymer PROMUS Element (PE) EES. The current analysis describes the six-month IVUS and clinical results through two years from the EVOLVE FHU trial. CONCLUSIONS: At six months, everolimus delivered from an ultrathin bioabsorbable abluminal polymer resulted in equivalent net volume obstruction and ISA compared with a permanent polymer EES. There were no significant differences between PE and either SYNERGY stent for any major cardiac endpoint through two years. Clinical trials number: NCT01135225. METHODS AND RESULTS: EVOLVE recruited 291 patients from 29 centres. At six months, IVUS-assessed in-stent net volume obstruction was 3.40 + 5.06% for PROMUS Element (PE) vs. 2.68 + 4.60% for SYNERGY (p=0.34) and 3.09 + 4.29% for SYNERGY 1/2 dose (p=0.68 vs. PE). There were no significant differences between groups for any other measured IVUS parameter including resolved, persistent, and late-acquired incomplete stent apposition (ISA). At two years, target lesion failure (TLF) was 6.1% for PE vs. 5.5% for SYNERGY (p=0.87) and 5.2% for SYNERGY 1/2 dose (p=0.81). There were no significant differences between groups for cardiac death, repeat revascularisation, MI or stent thrombosis through two years.


English

1774-024X


*Cardiovascular Agents/ad [Administration & Dosage]
*Coated Materials, Biocompatible
*Coronary Artery Disease/th [Therapy]
*Coronary Vessels/us [Ultrasonography]
*Drug-Eluting Stents
*Percutaneous Coronary Intervention/is [Instrumentation]
*Polymers
*Sirolimus/aa [Analogs & Derivatives]
*Ultrasonography, Interventional
Australia
Chi-Square Distribution
Coronary Angiography
Coronary Artery Disease/di [Diagnosis]
Coronary Artery Disease/mo [Mortality]
Coronary Restenosis/et [Etiology]
Coronary Restenosis/us [Ultrasonography]
Coronary Thrombosis/et [Etiology]
Coronary Thrombosis/us [Ultrasonography]
Europe
Humans
Kaplan-Meier Estimate
Myocardial Infarction/et [Etiology]
Myocardial Infarction/us [Ultrasonography]
New Zealand
Percutaneous Coronary Intervention/ae [Adverse Effects]
Percutaneous Coronary Intervention/mo [Mortality]
Predictive Value of Tests
Prosthesis Design
Risk Factors
Sirolimus/ad [Administration & Dosage]
Time Factors
Treatment Outcome


MedStar Heart & Vascular Institute


Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't