title: Long-term comparison of everolimus-eluting and sirolimus-eluting stents for coronary revascularization.
abstract: OBJECTIVE
  This study sought to compare the unrestricted use of everolimus-eluting stents (EES) with sirolimus-eluting stents (SES) in patients undergoing percutaneous coronary intervention.
  
  
  BACKGROUND
  It is unclear whether there are differences in safety and efficacy between EES and SES during long-term follow-up.
  
  
  METHODS
  Using propensity score matching, clinical outcome was compared among 1,342 propensity score-matched pairs of patients treated with EES and SES. The primary outcome was a composite of death, MI, and target vessel revascularization.
  
  
  RESULTS
  The median follow-up was 1.5 years with a maximum of 3 years. The primary outcome occurred in 14.9% of EES- and 18.0% of SES-treated patients up to 3 years (hazard ratio [HR]: 0.83, 95% confidence interval [CI]: 0.68 to 1.00, p = 0.056). All-cause mortality (6.0% vs. 6.5%, HR: 0.92, 95% CI: 0.68 to 1.25, p = 0.59) was similar, risks of myocardial infarction (MI) (3.3% vs. 5.0%, HR: 0.62, 95% CI: 0.42 to 0.92, p = 0.017), and target vessel revascularization (7.0% vs. 9.6%, HR: 0.75, 95% CI: 0.57 to 0.99, p = 0.039) were lower with EES than SES. Definite stent thrombosis (ST) (HR: 0.30, 95% CI: 0.12 to 0.75, p = 0.01) was less frequent among patients treated with EES. The reduced rate of MI with EES was explained in part by the lower risk of definite ST and the corresponding decrease in events associated with ST (HR: 0.25, 95% CI: 0.08 to 0.75, p = 0.013).
  
  
  CONCLUSIONS
  The unrestricted use of EES appears to be associated with improved clinical long-term outcome compared with SES. Differences in favor of EES are driven in part by a lower risk of MI associated with ST.
authors: Department of Cardiology, Bern University Hospital, Bern, Switzerland.
authors: Lorenz
authors: L
authors: Räber
authors: Peter
authors: P
authors: Jüni
authors: Eveline
authors: E
authors: Nüesch
authors: Bindu
authors: B
authors: Kalesan
authors: Peter
authors: P
authors: Wenaweser
authors: Aris
authors: A
authors: Moschovitis
authors: Ahmed A
authors: AA
authors: Khattab
authors: Maryam
authors: M
authors: Bahlo
authors: Mario
authors: M
authors: Togni
authors: Stéphane
authors: S
authors: Cook
authors: Rolf
authors: R
authors: Vogel
authors: Christian
authors: C
authors: Seiler
authors: Bernhard
authors: B
authors: Meier
authors: Stephan
authors: S
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