Five-year outcomes of sirolimus-eluting versus paclitaxel-eluting stents: a propensity matched study: clinical evidence of late catch-up?
BACKGROUND
Siroliums-eluting stents (SES) and paclitaxel-eluting stents (PES) have been widely used for the treatment of coronary artery disease. We investigated 5-year clinical outcomes of patients treated with SES versus PES in a multicenter registry.


METHODS
We used a propensity score matching method with 2:1 matching, including 512 patients treated with SES and 256 patients treated with PES from March 2003 to December 2004. The primary endpoint was major adverse cardiac events, which included all-cause death, myocardial infarction (MI), and target vessel revascularization (TVR).


RESULTS
After matching, baseline characteristics were similar between the two groups. At 5 years, cumulative survival free of major adverse cardiac events, MI, and stent thrombosis did not differ between the two groups. Survival free of TVR at 5 years was higher in the SES group (88.4%) than the PES group (84.3%, Log-rank p=0.016). In contrast to the trend toward more likely target lesion revascularization in the PES group during the first 2 years (hazard ratio 0.62, p=0.057), target lesion revascularization tended to occur more frequently in the SES group from 2 to 5 years (hazard ratio 2.26, p=0.099).


CONCLUSIONS
Long-term risk of TVR was slightly lower with SES, compared with PES, despite no significant difference in major adverse cardiac events. However, the SES group had more frequent target lesion reintervention 2 to 5 years after stent implantation, whereas reintervention in the PES group occurred mainly within the first 2 years. This may reflect the temporal difference in neointimal growth of the two stent types.
Ko
Young-Guk
YG
Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea.
Kim
Jung-Sun
JS
Choi
Donghoon
D
Hong
Myeong-Ki
MK
Min
Pil-Ki
PK
Yoon
Young Won
YW
Hong
Bum-Kee
BK
Lee
Byoung-Kwon
BK
Kwon
Hyuck-Moon
HM
Kim
Byeong-Keuk
BK
Oh
Sung-Jin
SJ
Jeon
Dong-Wun
DW
Yang
Joo-Young
JY
Jang
Yangsoo
Y
D000368:Aged; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D057216:Propensity Score; D012042:Registries; D020123:Sirolimus / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome
D017239:Paclitaxel; D020123:Sirolimus