title: Sirolimus-eluting stent versus paclitaxel-eluting stent for patients with long coronary artery disease.
abstract: BACKGROUND
  Outcomes remain relatively unfavorable for stent-based coronary intervention of lesions with long diseased segments. This study compared sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) for long coronary lesions.
  
  
  RESULTS
  The present randomized, multicenter, prospective study compared the use of long (> or =32 mm) SES with PES in 500 patients with long (> or =25 mm) native coronary lesions. The primary end point of the trial was the rate of binary in-segment restenosis according to follow-up angiography at 6 months. The SES and PES groups had similar baseline characteristics. Lesion length was 33.9+/-11.6 mm in the SES group and 34.5+/-12.6 mm in the PES group (P=0.527). The in-segment binary restenosis rate was significantly lower in the SES group than in the PES group (3.3% versus 14.6%; relative risk 0.23; P<0.001). In-stent late loss of lumen diameter was 0.09+/-0.37 mm in the SES group and 0.45+/-0.55 mm in the PES group (P<0.001). In patients with restenoses, a pattern of focal restenosis was more common in the SES group than in the PES group (100% versus 53.3%, P=0.031). Consequently, SES patients had a lower rate of target-lesion revascularization at 9 months (2.4% versus 7.2%, P=0.012). The incidence of death (0.8% in SES versus 0% in PES, P=0.499) or myocardial infarction (8.8% in SES versus 10.8% in PES, P=0.452) at 9 months of follow-up was not statistically different between the 2 groups.
  
  
  CONCLUSIONS
  For patients with long native coronary artery disease, SES implantation was associated with a reduced incidence of angiographic restenosis and a reduced need for target-lesion revascularization compared with PES implantation.
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: Seung-Whan
authors.initials: SW
authors.lastname: Lee
authors.forename: Duk-Woo
authors.initials: DW
authors.lastname: Park
authors.forename: Sung-Cheol
authors.initials: SC
authors.lastname: Yun
authors.forename: Cheol Whan
authors.initials: CW
authors.lastname: Lee
authors.forename: Myeong-Ki
authors.initials: MK
authors.lastname: Hong
authors.forename: Hyun-Sook
authors.initials: HS
authors.lastname: Kim
authors.forename: Jae-Ki
authors.initials: JK
authors.lastname: Ko
authors.forename: Jae-Hyeong
authors.initials: JH
authors.lastname: Park
authors.forename: Jae-Hwan
authors.initials: JH
authors.lastname: Lee
authors.forename: Si Wan
authors.initials: SW
authors.lastname: Choi
authors.forename: In-Whan
authors.initials: IW
authors.lastname: Seong
authors.forename: Yoon Haeng
authors.initials: YH
authors.lastname: Cho
authors.forename: Nae-Hee
authors.initials: NH
authors.lastname: Lee
authors.forename: June Hong
authors.initials: JH
authors.lastname: Kim
authors.forename: Kook-Jin
authors.initials: KJ
authors.lastname: Chun
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy; D016503:Drug Delivery Systems; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology; D017239:Paclitaxel / Q000008:administration & dosage*; D019233:Retreatment; D020123:Sirolimus / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D017239:Paclitaxel; D020123:Sirolimus