2199Rate of very late stent thrombosis differs between drug-eluting stents: a 5-year pooled landmark analysis of the SORT OUT III, IV, and V trials

Abstract

Background: Very late stent thrombosis (VLST) is of major concern following coronary drug‐eluting stent implantation. Purpose: We examined the rate of VLST for 4 different drug‐eluting stents. Methods: We pooled individual 5‐year data from the randomized clinical SORT OUT III, IV, and V trials. These 3 trials treated patients with 3 permanent‐polymer stents, the Cypher sirolimus‐eluting (C‐SES, n=3764 patients), the Endeavor zotarolimus‐eluting (E‐ZES, n=1162), the Xience V/Promus everolimus‐eluting stents (EES, n=1376), and the absorbable‐polymer Nobori biolimus‐eluting stent (BES, n=1214) stents. VLST was defined according to the Academic Research Consortium definition and thus evaluated the period between >12 to 60 months. C‐SES was the comparator stent. Relative risk (RR) and adjusted RR were calculated. Results: A total of 70 VLST cases were observed (C‐SES: n=55 (1.48%); EZES: n=2 (0.09%); EES: n=1 (0.15%); BES: n=12 (1.0%)). In comparison to the C‐SES, the other 2 permanent‐polymer stents were associated with a reduced rate of VLST while the absorbable‐polymer BES did not significantly reduce the risk of VLST (E‐ZES: 0.06; 95% CI 0.01‐0.44; EES: 0.10, 95% CI 0.02‐0.40; BES: 0.67, 95% CI 0.36‐1.25). Adjustment for baseline characteristics did not change this result. Conclusions: The rate of VLST differed between drug‐eluting stents. VLST was almost eliminated by use of E‐ZES and EES.