Sirolimus versus paclitaxel-eluting stents in small coronary vessels: long-term outcomes from a single-center registry.
OBJECTIVE
Several studies showed that small vessel diameter is a determinant of increased risk of adverse events after stenting. The efficacy of different drug-eluting stent types implanted in small vessels has still not been established. The aim of the present observational study was to compare long-term clinical outcomes after sirolimus-eluting stent (SES) or paclitaxel-eluting stent (PES) implantation in lesions located in small coronary vessels.


METHODS
For the purpose of this analysis patients undergoing SES or PES implantation in vessels with diameter 2.5 mm or less, from May 2002 to December 2006, were included. Long-term rates of major adverse cardiac events were evaluated and compared between the two groups. Independent predictors of major adverse cardiac events were also investigated.


RESULTS
A total of 336 patients were included, 225 were treated only with SES and 111 only with PES. During a mean follow-up of 23.3 +/- 12.1 months the major adverse cardiac events rates were 12.8 versus 13.6%, P = 0.98 in SES versus PES groups, respectively. The rates of target lesion revascularization (8.0 versus 6.3%, P = 0.75), mortality (3.5 versus 4.5%, P = 0.88) and myocardial infarction (2.6 versus 4.5%, P = 0.41) were similar between SES and PES, respectively. The overall thrombosis rate was also not significantly different in SES and PES groups (1.3% SES versus 4.5% PES, P = 0.12).


CONCLUSIONS
In this study SES and PES provided similar long-term results after treatment of lesions in small vessels. Nevertheless, larger randomized studies are needed to confirm these findings.
Institute of Cardiology Ferrarotto Hospital, University of Catania, Catania, Italy. ritabuk@hotmail.com
Rita
R
Bucalo
Piera
P
Capranzano
Giorgio
G
Conti
Davide
D
Capodanno
Cettina
C
Ruperto
Anita
A
Blundo
Anna
A
Caggegi
Claudia
C
Tamburino
Alessandra
A
Sanfilippo
Corrado
C
Tamburino
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D017239:Paclitaxel / Q000627:therapeutic use*; D012189:Retrospective Studies; D020123:Sirolimus / Q000627:therapeutic use*; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D017239:Paclitaxel; D020123:Sirolimus