title: Two-year clinical, angiographic, and intravascular ultrasound follow-up of the XIENCE V everolimus-eluting stent in the treatment of patients with de novo native coronary artery lesions: the SPIRIT II trial.
abstract: BACKGROUND
  This article reports the 2-year clinical, angiographic, and intravascular ultrasound outcomes of the everolimus-eluting stent (EES) compared with the paclitaxel-eluting stent (PES) in the randomized SPIRIT II trial.
  
  
  RESULTS
  This was a prospective, single-blind clinical trial in which a total of 300 patients with de novo native coronary artery lesions were randomized to either EES or PES in a 3:1 fashion. Clinical follow-up was planned at 2 years in all patients. A subset of 152 patients underwent serial angiographic and intravascular ultrasound analyses at 6 months and 2 years. After 2 years, target lesion failure (cardiac death, myocardial infarction, and ischemia-driven target lesion revascularization) rates were 6.6% and 11% in EES and PES, respectively (P=0.31). At 6 months, a significant reduction in angiographic in-stent late loss and percentage volume obstruction measured by intravascular ultrasound was observed in the EES group. However, at 2-year follow-up, a late increased intimal hyperplasia growth after implantation of an EES was observed. There were no significant differences between EES and PES for in-stent late loss (EES, 0.33+/-0.37 mm versus PES, 0.34+/-0.34 mm; P=0.84) and percentage volume obstruction (EES, 5.18+/-6.22% versus PES, 5.80+/-6.31%; P=0.65) at 2 years. The incidence of stent thrombosis was low and comparable in both groups (EES, 0.9%; PES, 1.4%).
  
  
  CONCLUSIONS
  Although the previously reported angiographic and clinical superiority of the EES has vanished over time, this report confirms and extends the previously demonstrated noninferiority in terms of in-stent late loss of the EES when compared with the PES up to 2-year follow-up. There were no significant differences between EES and PES in clinical, angiographic and intravascular ultrasound outcomes at 2 years.
authors.affiliation: Department of Cardiology, Academic Medical Center, University of Amsterdam, The Netherlands. B.E.Claessen@amc.uva.nl
authors.forename: Bimmer E
authors.initials: BE
authors.lastname: Claessen
authors.forename: Marcel A
authors.initials: MA
authors.lastname: Beijk
authors.forename: Victor
authors.initials: V
authors.lastname: Legrand
authors.forename: Witold
authors.initials: W
authors.lastname: Ruzyllo
authors.forename: Antonio
authors.initials: A
authors.lastname: Manari
authors.forename: Olivier
authors.initials: O
authors.lastname: Varenne
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Suttorp
authors.forename: Jan G P
authors.initials: JG
authors.lastname: Tijssen
authors.forename: Karine
authors.initials: K
authors.lastname: Miquel-Hebert
authors.forename: Susan
authors.initials: S
authors.lastname: Veldhof
authors.forename: Jose P S
authors.initials: JP
authors.lastname: Henriques
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Piek
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents; D005060:Europe; D000068338:Everolimus; D005260:Female; D006801:Humans; D007194:India; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000209:etiology; D009520:New Zealand; D017239:Paclitaxel / Q000008:administration & dosage*; D011446:Prospective Studies; D016037:Single-Blind Method; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D002317:Cardiovascular Agents; D000068338:Everolimus; D017239:Paclitaxel; D020123:Sirolimus