title: Comparison of sirolimus-eluting stent, paclitaxel-eluting stent, and bare metal stent in the treatment of long coronary lesions.
abstract: OBJECTIVE
  This study compared the efficacy of the sirolimus-eluting stent (SES), the paclitaxel-eluting stent (PES), and the bare metal stent (BMS) for long coronary lesions.
  
  
  BACKGROUND
  The outcome of drug-eluting stent (DES) implantation in long coronary lesions remains unclear.
  
  
  METHODS
  The study involved 527 patients with de novo long coronary lesions (> or = 24 mm), which were treated with long (> or = 28 mm) SESs (223 lesions), PESs (194 lesions), or BMSs (201 lesions).
  
  
  RESULTS
  Lesions in the SES (36.0 +/- 14.9 mm, P < 0.001) and PES (36.3 +/- 14.5 mm, P < 0.001) groups were longer than those in the BMS group (32.0 +/- 12.3 mm), meaning the two DES groups had longer stented segments than did the BMS group. Six-month angiographic follow-up showed the SES (9.3%, P < 0.001) and PES (21.3%, P < 0.001) groups had lower in-segment restenosis rates than that of the BMS group (42.5%). The rate of major adverse cardiac events (MACE) including death, myocardial infarction, and target lesion revascularization at 9 months was higher in the BMS group (26.6%) than that in the SES (13.0%, P < 0.001) and PES (15.7%, P < 0.001) groups. Posthoc analysis of the two DES groups showed that the in-segment restenosis rate was lower for the SES than that for the PES group (P = 0.002), while the MACE rate was similar.
  
  
  CONCLUSIONS
  The use of DESs for long coronary lesions appears to be safe and more effective than the use of BMSs in terms of restenosis and adverse clinical events. SES use was associated with lower late luminal loss and a lower angiographic restenosis rate compared with PES use.
authors.affiliation: Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Young-Hak
authors.initials: YH
authors.lastname: Kim
authors.forename: Seong-Wook
authors.initials: SW
authors.lastname: Park
authors.forename: Cheol Whan
authors.initials: CW
authors.lastname: Lee
authors.forename: Myeong-Ki
authors.initials: MK
authors.lastname: Hong
authors.forename: Hyeon-Cheol
authors.initials: HC
authors.lastname: Gwon
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.forename: Myoung Mook
authors.initials: MM
authors.lastname: Lee
authors.forename: Bon Kwon
authors.initials: BK
authors.lastname: Koo
authors.forename: Dong Joo
authors.initials: DJ
authors.lastname: Oh
authors.forename: Ki Bae
authors.initials: KB
authors.lastname: Seung
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Tahk
authors.forename: Junghan
authors.initials: J
authors.lastname: Yoon
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000704:Analysis of Variance; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000628:therapy*; D023903:Coronary Restenosis / Q000517:prevention & control; D016503:Drug Delivery Systems; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008670:Metals; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D011446:Prospective Studies; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents
chemical_list: D002317:Cardiovascular Agents; D008670:Metals; D017239:Paclitaxel; D020123:Sirolimus