title: One-year outcome of small-vessel disease treated with sirolimus-eluting stents: a subgroup analysis of the e-SELECT registry.
abstract: OBJECTIVE
  To investigate the characteristics and one-year outcomes following sirolimus-eluting CYPHER Select Plus stent (SES) implantation in small (SmVD) and non-small vessel disease (NSmVD) in the international e-SELECT registry.
  
  
  BACKGROUND
  Large-scale registry data are lacking on DES outcomes in SmVD treatment.
  
  
  METHODS
  There were 4,700 SmVD (at least one vessel with estimated reference vessel diameter [RVD] < 2.5 mm, excluding 283 patients with unknown RVD vessels) and 10,139 NSmVD only patients.
  
  
  RESULTS
  The SmVD population was older, with more women, diabetics, and vessels treated, higher mean Charlson Comorbidity Index score (CCI), shorter lesions, and less STEMI presentation. The 1-year stent thrombosis (ST) rate (primary end-point), was significantly higher (1.3% vs. 0.7%) in SmVD versus NSmVD, mainly driven by early events. One-year major adverse cardiac event (MACE), myocardial infarction (MI), and clinically indicated target-lesion revascularization (TLR) rates were significantly higher in SmVD although death and major bleeding rates were similar in both groups. Complication rates were similar between pure (3,188 patients; only RVD < 2.5 mm) and mixed (1,795 patients; some RVD < 2.5 mm or unknown RVD) SmVD. Multivariate predictors for 1-year MACE in SmVD included saphenous vein graft or bifurcation lesions, major bleeding, any antiplatelet therapy discontinuation within 1 month, age, number of stents implanted, CCI, acute coronary syndrome, and insulin-dependent diabetes mellitus.
  
  
  CONCLUSIONS
  SES implantation for SmVD occurs more frequently in women, diabetics, and those with multivessel disease and comorbidities. One-year ST, MACE, MI, and clinically indicated TLR rates are higher, although low overall, in SmVD or mixed SmVD patients while death rates are similar to NSmVD.
authors.affiliation: Cardiovascular Institute and Fu Wai Hospital, Beijing, China. gaorunlin@citmd.com
authors.forename: Runlin
authors.initials: R
authors.lastname: Gao
authors.forename: Alexandre
authors.initials: A
authors.lastname: Abizaid
authors.forename: Adrian
authors.initials: A
authors.lastname: Banning
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Bartorelli
authors.forename: Vladimír
authors.initials: V
authors.lastname: Džavík
authors.forename: Stephen
authors.initials: S
authors.lastname: Ellis
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Victor
authors.initials: V
authors.lastname: Legrand
authors.forename: Christian
authors.initials: C
authors.lastname: Spaulding
authors.forename: Philip
authors.initials: P
authors.lastname: Urban
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000601:surgery*; D023903:Coronary Restenosis / Q000453:epidemiology / Q000209:etiology*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012042:Registries; D020123:Sirolimus / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D020123:Sirolimus