Sirolimus-eluting stent showed better one-year outcomes than paclitaxel-eluting stent in a real life setting of coronary intervention in Koreans.
OBJECTIVE
The drug-eluting stent (DES) has been proven its efficacy in randomized trials. But the difference of efficacy between sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) in unselected patients is in controversy. Therefore, we investigated the clinical and angiographic outcomes of these two types of the DES.


METHODS
All consecutive patients treated with DES from March 2003 to March 2004 at two centers were analyzed.


RESULTS
We analyzed 440 patients with 519 lesions who were treated with the two types of DES (SES 353 lesions/296 patients, PES 166 lesions/144 patients). PES group had more acute myocardial infarction (AMI) patients. Angiographically, the number of stents per lesion, maximal deployment pressure, stent diameter and the percent residual stenosis after procedure were different between the two groups. Angiographic follow-up was available in 103 patients (71.5%) in the PES group and 208 patients (70.3%) in the SES group. PES showed the higher binary restenosis rate (PES 17.9%, SES 4.5%, p<0.0001) and the larger late loss (PES 0.60x0.83 mm vs. SES 0.16x0.40 mm, p<0.001) than SES. PES was the predictor of binary restenosis at six months (OR 4.67, CI 2.20-9.91). At one year follow-up, PES also had more cardiac events (composites of death of all cause, MI, and target lesion revascularization) than SES (PES 13.9% vs. SES 6.1%, p<0.001). PES was a significant predictor of cardiac events at one year (OR 2.47, CI 1.23-4.95).


CONCLUSIONS
SES showed better clinical and angiographic outcomes compared to PES in a daily routine practice of coronary intervention in Koreans.
Suh
Jung-Won
JW
Department of Internal Medicine, Seoul National University College of Medicine, Korea.
Park
Jin-Shik
JS
Cho
Hyun-Jai
HJ
Kim
Min-Seok
MS
Kang
Hyun-Jae
HJ
Cho
Young-Seok
YS
Koo
Bon-Kwon
BK
Chung
Woo-Young
WY
Youn
Tae-Jin
TJ
Chae
In-Ho
IH
Choi
Dong-Ju
DJ
Kim
Hyo-Soo
HS
Sohn
Dae-Won
DW
Oh
Byung-Hee
BH
Park
Young-Bae
YB
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D023903:Coronary Restenosis; D023921:Coronary Stenosis / Q000150:complications / Q000628:therapy*; D016503:Drug Delivery Systems; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology; D016017:Odds Ratio; D017239:Paclitaxel / Q000008:administration & dosage*; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D017239:Paclitaxel; D020123:Sirolimus