title: Twenty-four months clinical outcomes of sirolimus-eluting stents for the treatment of small coronary arteries: the long-term SES-SMART clinical study.
abstract: OBJECTIVE
  It has been demonstrated that, in comparison with bare-metal stents (BMS), sirolimus-eluting stents (SES) reduce restenosis after the percutaneous revascularization of small coronary arteries, but the long-term clinical outcomes of this treatment have not yet been investigated.
  
  
  RESULTS
  The long-term SES-SMART clinical study was a multicentre, prospective, randomized, single-blind study of 257 patients receiving a SES or BMS in a small coronary artery, who were evaluated at discharge, 30 days, 8 and 24 months after stenting. The clinical endpoint of the study was a 24 months composite of major adverse cardiac and cerebrovascular events, which included death, non-fatal myocardial infarction, ischaemia-driven target lesion revascularization (TLR), and cerebrovascular accident. The 24 months follow-up was completed by 254 patients (98.8%). The use of SES was associated with a significantly lower incidence of the clinical endpoint (12.6% vs. 33.1%; HR 0.30, 95% CI: 0.17-0.55; P < 0.0001), which was not only due to a reduction in TLR (7.9% vs. 29.9%; HR 0.30, 95% CI: 0.16-0.59; P < 0.0001), but also to a reduction in myocardial infarction (1.6% vs. 10.2%; HR 0.09, 95% CI: 0.01-0.66; P = 0.018).
  
  
  CONCLUSIONS
  In comparison with BMS, the use of SES in the percutaneous revascularization of small coronary arteries is associated with improved clinical outcomes after 2 years follow-up.
authors.affiliation: Unità Operativa di Cardiologia, Dipartimento Cardio-Polmonare, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy. almenozzi@ao.pr.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Menozzi
authors.forename: Emilia
authors.initials: E
authors.lastname: Solinas
authors.forename: Paolo
authors.initials: P
authors.lastname: Ortolani
authors.forename: Alessandra
authors.initials: A
authors.lastname: Repetto
authors.forename: Francesco
authors.initials: F
authors.lastname: Saia
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Piovaccari
authors.forename: Antonio
authors.initials: A
authors.lastname: Manari
authors.forename: Enrico
authors.initials: E
authors.lastname: Magagnini
authors.forename: Luigi
authors.initials: L
authors.lastname: Vignali
authors.forename: Erminio
authors.initials: E
authors.lastname: Bonizzoni
authors.forename: Piera Angelica
authors.initials: PA
authors.lastname: Merlini
authors.forename: Claudio
authors.initials: C
authors.lastname: Cavallini
authors.forename: Diego
authors.initials: D
authors.lastname: Ardissino
mesh_terms: D000368:Aged; D002561:Cerebrovascular Disorders / Q000209:etiology / Q000401:mortality; D023903:Coronary Restenosis / Q000401:mortality / Q000628:therapy*; D016757:Death, Sudden, Cardiac / Q000209:etiology; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D009204:Myocardial Revascularization / Q000401:mortality; D011446:Prospective Studies; D012307:Risk Factors; D016037:Single-Blind Method; D020123:Sirolimus / Q000008:administration & dosage*; D016896:Treatment Outcome; D050257:Tubulin Modulators / Q000008:administration & dosage*
chemical_list: D050257:Tubulin Modulators; D020123:Sirolimus