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Safety of ENdeavorTM Stent (Zotarolimus-eluting Stent) Associated with Non-cardiac Surgical Procedure and Brief Interruption of Dual Anti-platelet Agents within 12 Months Following Stent Implantation (SENS): a Multicenter Study
고려대구로¹,가천의대² ,제주의대³ ,경희의대⁴,계명의대 5 ,고려대안암6,강원대 7,고려대안산 8,홍익 9,성균관대10,전남대11
김진원¹, 강웅철², 김기석³,김수중⁴,남창욱5,안철민 6,이봉기 7,임상협 8,정현숙 9,최진호10, 홍영준11,오동주¹
Background: Bare-metal stent is preferable to 1st generation drug-eluting stent in patients who need non-cardiac surgery within 12 months from coronary stenting despite restenosis. However, data are lacking regarding the safety of EndeavorTM stent (Zotarolimus-eluting stent;ZES) which has been known to carry a lower risk of stent thrombosis due to rapid re-endothelialization. Methods: A total of 3098 consecutive patients treated with ZES since January 2006 were retrospectively analyzed in Korean 11 teaching hospitals. The primary endpoint was the 30-day major adverse cardiac events(MACE) including death, non-fatal myocardial infarction (MI) and target lesion revascularization. Results: 193 patients (6.2 %) with brief interruption of both aspirin and clopidogrel due to non-cardiac surgical procedure within 12 months following ZES implantation were identified. Four patients (2.1 %) experienced a MACE (2 patients: fatal, 2 patients: non-fatal MI with identified thrombus). The incidence of MACE was higher in the early-surgery group (within 3 months following stent implantation) than in the late-surgery group (3 months to 12 months after stent implantation)(Table).Conclusion: ZES appears to be safe and feasible in patients undergoing non-cardiac surgical procedure after 3 months following stent implantation.

Early surgery group
(n=34)

Late surgery group
(n=159)

p-value

Age (yrs)/Male (%)

62.2/63.5

63.1/50.9

NS

Lesion type (B2/C) (%)

73.6

72.8

NS

Stent number

1.4

1.5

NS

Mean stent diameter (mm)

3.11±0.52

3.08±0.47

NS

Total stent length (mm)

33.0±16.7

29.2±19.5

NS

Major surgery (%)

20.5

22.8

NS

Days from stenting to surgery

56.5

233.7

<0.001

DAP withdrawal (days)

13.4

14.8

NS

MACE (%)

8.9 (2 Death, 1 MI)

0.6 (1 MI)

<0.001

NS: no significant, DAP: dual antiplatelet agents



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