Outcomes after unrestricted use of everolimus-eluting and sirolimus-eluting stents in routine clinical practice: a multicenter, prospective cohort study.
BACKGROUND
It remains unclear whether there are differences in the safety and efficacy outcomes between everolimus-eluting stents (EES) and sirolimus-eluting stents (SES) in contemporary practice.


RESULTS
We prospectively enrolled 6166 consecutive patients who received EES (3081 patients) and SES (3085 patients) between April 2008 and June 2010, using data from the Interventional Cardiology Research In-Cooperation Society-Drug-Eluting Stents Registry. The primary end point was a composite of death, nonfatal myocardial infarction (MI), or target-vessel revascularization (TVR). At 2 years of follow-up, the 2 study groups did not differ significantly in crude risk of the primary end point (12.1% for EES versus 12.4% for SES; HR, 0.97; 95% CI, 0.84-1.12, P=0.66). After adjustment for differences in baseline risk factors, the adjusted risk for the primary end point remained similar for the 2 stent types (HR, 0.96; 95% CI, 0.82-1.12, P=0.60). There were also no differences between the stent groups in the adjusted risks of the individual component of death (HR, 0.93; 95% CI, 0.67-1.30, P=0.68), MI (HR, 0.97; 95% CI, 0.79-1.18, P=0.74), and TVR (HR, 1.10; 95% CI, 0.82-1.49, P=0.51). The adjusted risk of stent thrombosis also was similar (HR, 1.16; 95% CI, 0.47-2.84, P=0.75).


CONCLUSIONS
In contemporary practice of percutaneous coronary intervention procedures, the unrestricted use of EES and SES showed similar rates of safety and efficacy outcomes with regard to death, MI, sent thrombosis, and TVR. Future longer-term follow-up is needed to better define the relative benefits of these drug-eluting stents.


BACKGROUND
URL: http://www.clinicaltrials.gov. Unique identifier: NCT01070420.
Department of Cardiology, Center for Medical Research and Information, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Duk-Woo
DW
Park
Young-Hak
YH
Kim
Hae-Geun
HG
Song
Jung-Min
JM
Ahn
Won-Jang
WJ
Kim
Jong-Young
JY
Lee
Soo-Jin
SJ
Kang
Seung-Whan
SW
Lee
Cheol Whan
CW
Lee
Seong-Wook
SW
Park
Sung-Cheol
SC
Yun
Sung Ho
SH
Her
Seung Ho
SH
Hur
Jin Sik
JS
Park
Myeong-Kon
MK
Kim
Yun Seok
YS
Choi
Hyun Sook
HS
Kim
Jang-Hyun
JH
Cho
Sang Gon
SG
Lee
Yong Whi
YW
Park
Myung-Ho
MH
Jeong
Bong Ki
BK
Lee
Nae-Hee
NH
Lee
Do-Sun
DS
Lim
Junghan
J
Yoon
Ki Bae
KB
Seung
Won-Yong
WY
Shin
Seung-Woon
SW
Rha
Kee-Sik
KS
Kim
Seung-Jea
SJ
Tahk
Byoung Eun
BE
Park
Taehoon
T
Ahn
Joo-Young
JY
Yang
Yong Seok
YS
Jeong
Jay-Hyun
JH
Rhew
Seung-Jung
SJ
Park
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D003328:Coronary Thrombosis / Q000209:etiology; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011474:Prosthesis Design; D012042:Registries; D056910:Republic of Korea; D018570:Risk Assessment; D012307:Risk Factors; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013997:Time Factors; D016896:Treatment Outcome
D002317:Cardiovascular Agents; D000068338:Everolimus; D020123:Sirolimus