Comparison of the effectiveness of sirolimus- and paclitaxel-eluting stents for small coronary artery lesions.
BACKGROUND
The sirolimus-eluting stent (SES) and the paclitaxel-eluting stent (PES) reduce restenosis in small coronary artery lesions. However, it is not clear which of these stents is superior in terms of clinical outcomes.


METHODS
The authors retrospectively examined 197 patients with 245 de novo small coronary artery lesions (<or=<or=2.75 mm) that were treated with either the SES (156 lesions) or the PES (89 lesions). Six-month angiographic restenosis rates and the 9-month target lesion revascularization (TLR) rates were compared between the two groups.


RESULTS
In terms of baseline clinical and angiographic parameters, the two groups well matched together. Six-month angiographic follow-up was performed on 170 patients (86.3%), comprising 135 SES lesions (86.5%) and 76 PES lesions (85.4%). At 6-month angiographic follow-up, the late lumen loss was less in the SES group than in the PES group (0.29 +/- 0.42 vs. 0.69 +/- 0.63 mm, P < 0.01). Therefore, the SES group showed a lower rate of angiographic restenosis than the PES group (6.7% vs. 27.7%, P < 0.01). At 9 months there were no deaths or myocardial infarctions in either group. The 9-month TLR rate was lower in the SES group than in the PES group (3.3% vs. 14.4%, P < 0.01). The Kaplan-Meier estimate of freedom from TLR at 9 months was 96.7% for the SES patients and 86.5% for the PES patients (P < 0.01).


CONCLUSIONS
The SES treatment may be superior to the PES treatment in terms of long-term clinical and angiographic outcomes in patients with small coronary artery lesions.
Park
Kyoung-Ha
KH
Department of Medicine, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu, Seoul, Korea.
Park
Seong-Wook
SW
Hong
Myeong-Ki
MK
Kim
Young-Hak
YH
Lee
Bong-Ki
BK
Park
Duk-Woo
DW
Choi
Bong-Ryong
BR
Kim
Mi-Jeong
MJ
Park
Kyoung-Min
KM
Lee
Cheol Whan
CW
Cheong
Sang-Sig
SS
Kim
Jae-Joong
JJ
Park
Seung-Jung
SJ
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D023903:Coronary Restenosis / Q000517:prevention & control; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D017239:Paclitaxel; D020123:Sirolimus