title: Rationale and design for the PAINT randomized trial.
abstract: BACKGROUND
  We describe the rationale and design for the 'PercutAneous INTervention with biodegradable-polymer based paclitaxel-eluting or sirolimus-eluting versus bare stents for de novo coronary lesions - PAINT trial'.
  
  
  OBJECTIVE
  To evaluate two novel formulations of paclitaxel-eluting stent and the sirolimus-eluting stent against a stent with the same metallic structure but without polymer coating or drug elution.
  
  
  METHODS
  The PAINT is a multicenter 3-arm randomized trial, conducted in Brazilian tertiary institutions, which included 275 patients allocated for the InfinniumR paclitaxel-eluting stent, the SupralimusR sirolimus-eluting stent or the Milennium MatrixR bare metal stent in a 2:2:1 ratio. Patients had de novo coronary lesions in native vessels with a diameter between 2.5 and 3.5 mm, amenable for treatment with a single stent of 29 mm or less in length. The primary objective was to compare the in-stent late loss at 9 months of both paclitaxel- and sirolimus-eluting versus the late loss of control bare metal stents. Important secondary objectives included the comparison in outcomes between sirolimus and paclitaxel stents, as well as the analysis of the incidence of major adverse cardiac events.
  
  
  CONCLUSIONS
  The PAINT trial had a unique design that allowed for the evaluation of the safety and efficacy profiles of two novel drug-eluting stent formulations, with a biodegradable-polymer carrier and releasing paclitaxel or sirolimus, which were compared against a bare metal stent (primary objective). As the drug-eluting stents differed by the drug, but were identical otherwise, the trial also allowed the comparison of the anti-restenosis effects of sirolimus versus paclitaxel (secondary objective).
authors.affiliation: Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil. pedro.lemos@incor.usp.br
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Lemos
authors.forename: Bruno
authors.initials: B
authors.lastname: Moulin
authors.forename: Marco A
authors.initials: MA
authors.lastname: Perin
authors.forename: Ludmilla A R R
authors.initials: LA
authors.lastname: Oliveira
authors.forename: J Airton
authors.initials: JA
authors.lastname: Arruda
authors.forename: Valter C
authors.initials: VC
authors.lastname: Lima
authors.forename: Antonio A G
authors.initials: AA
authors.lastname: Lima
authors.forename: Paulo R A
authors.initials: PR
authors.lastname: Caramori
authors.forename: Cesar R
authors.initials: CR
authors.lastname: Medeiros
authors.forename: Mauricio R
authors.initials: MR
authors.lastname: Barbosa
authors.forename: Fabio S
authors.initials: FS
authors.lastname: Brito
authors.forename: Expedito E
authors.initials: EE
authors.lastname: Ribeiro
authors.forename: Eulógio E
authors.initials: EE
authors.lastname: Martinez
mesh_terms: D020341:Absorbable Implants; D000293:Adolescent; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation* / Q000379:methods; D001938:Brazil / Q000453:epidemiology; D002317:Cardiovascular Agents / Q000008:administration & dosage; D003327:Coronary Disease / Q000473:pathology / Q000628:therapy*; D023903:Coronary Restenosis / Q000517:prevention & control; D003328:Coronary Thrombosis / Q000453:epidemiology / Q000209:etiology; D054855:Drug-Eluting Stents / Q000009:adverse effects; D004812:Epidemiologic Methods; D006801:Humans; D017239:Paclitaxel / Q000008:administration & dosage*; D011108:Polymers / Q000737:chemistry*; D011474:Prosthesis Design; D020123:Sirolimus / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002317:Cardiovascular Agents; D011108:Polymers; D017239:Paclitaxel; D020123:Sirolimus