Five-year clinical outcome after primary stenting of totally occluded native coronary arteries: a randomised comparison of bare metal stent implantation with sirolimus-eluting stent implantation for the treatment of total coronary occlusions (PRISON II study).
OBJECTIVE
The aim of this study was to examine the five-year clinical outcome in patients enrolled in the Primary Stenting of Totally Occluded Native Coronary Arteries II (PRISON II) study.


RESULTS
Patients with totally occluded coronary arteries were randomised to either sirolimus-eluting stent (SES, n=100) or bare metal stent (BMS, n=100) implantation. At five years, patients in the SES group had significantly lower rates of target lesion revascularisation (12% vs. 30%, p=0.001), target vessel revascularisation (17% vs. 34%, p=0.009) and major adverse cardiac events (12% vs. 36%, p<0.001). There were no significant differences in death and myocardial infarction. Eight (8%) cases of stent thrombosis (seven definite and one probable; one early, one late, and six very late) were noticed in the SES group versus three cases (3%, one definite and two possible; all very late) in the BMS group (p=0.21).


CONCLUSIONS
The results of the present study show that the documented superior short-term angiographic and clinical results of SES in patients with total coronary occlusions are maintained during long-term 5-year follow-up as compared with BMS. On the other hand, there is a trend to a higher stent thrombosis rate in the SES group.
St. Antonius Hospital, Nieuwegein, The Netherlands.
Ben J L
BJ
Van den Branden
Braim M
BM
Rahel
Gerrit J
GJ
Laarman
Ton
T
Slagboom
Johannes C
JC
Kelder
Juriën M
JM
Ten Berg
Maarten J
MJ
Suttorp
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods*; D015331:Cohort Studies; D054059:Coronary Occlusion / Q000401:mortality* / Q000628:therapy*; D023903:Coronary Restenosis / Q000453:epidemiology; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D020123:Sirolimus; D015607:Stents / Q000009:adverse effects; D015996:Survival Rate; D013927:Thrombosis / Q000453:epidemiology / Q000209:etiology; D016896:Treatment Outcome
D008670:Metals; D020123:Sirolimus