Unrestricted utilization of sirolimus-eluting stents compared with conventional bare stent implantation in the "real world": the Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital (RESEARCH) registry.
BACKGROUND
The effectiveness of sirolimus-eluting stents in unselected patients treated in the daily practice is currently unknown.


RESULTS
Sirolimus-eluting stent implantation has been used as the default strategy for all percutaneous procedures in our hospital as part of the Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital (RESEARCH) registry. Consecutive patients with de novo lesions (n=508) treated exclusively with sirolimus-eluting stents (SES group) were compared with 450 patients who received bare stents in the period just before (pre-SES group). Patients in the SES group more frequently had multivessel disease, more type C lesions, received more stents, and had more bifurcation stenting. At 1 year, the cumulative rate of major adverse cardiac events (death, myocardial infarction, or target vessel revascularization) was 9.7% in the SES group and 14.8% in the pre-SES group (hazard ratio [HR], 0.62 [95% CI, 0.44 to 0.89]; P=0.008). The 1-year risk of clinically driven target vessel revascularization in the SES group and in the pre-SES group was 3.7% versus 10.9%, respectively (HR, 0.35 [95% CI, 0.21 to 0.57]; P<0.001).


CONCLUSIONS
Unrestricted utilization of sirolimus-eluting stents in the "real world" is safe and effective in reducing both repeat revascularization and major adverse cardiac events at 1 year compared with bare stent implantation.
Lemos
Pedro A
PA
Erasmus Medical Center, Thoraxcenter, Rotterdam, The Netherlands.
Serruys
Patrick W
PW
van Domburg
Ron T
RT
Saia
Francesco
F
Arampatzis
Chourmouzios A
CA
Hoye
Angela
A
Degertekin
Muzaffer
M
Tanabe
Kengo
K
Daemen
Joost
J
Liu
Tommy K K
TK
McFadden
Eugene
E
Sianos
Georgios
G
Hofma
Sjoerd H
SH
Smits
Pieter C
PC
van der Giessen
Willem J
WJ
de Feyter
Pim J
PJ
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D023903:Coronary Restenosis / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D012042:Registries; D020123:Sirolimus / Q000008:administration & dosage* / Q000627:therapeutic use; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome
D020123:Sirolimus