title: Comparison of long-term outcomes between everolimus-eluting and sirolimus-eluting stents in small vessels.
abstract: Although second-generation everolimus-eluting stents (EESs) have demonstrated superiority over first-generation paclitaxel-eluting stents for a broad subset of patients and lesions, it is unclear whether the same applies to sirolimus-eluting stents (SESs). The present study compared the long-term clinical outcomes between EESs and SESs in patients with small coronary artery disease. A cohort of 643 patients treated with EESs (220 patients with 245 lesions) or SESs (423 patients with 523 lesions) in small vessel lesions (defined as those receiving stents ≤2.5 mm) were retrospectively analyzed. The end points included target lesion revascularization, target vessel revascularization, major adverse cardiovascular events (all-cause death, myocardial infarction, or target lesion revascularization), and definite stent thrombosis at 1 year of follow-up. The baseline characteristics were generally similar between the 2 groups, except that more systemic hypertension was seen in the EES group and more patients had a family history of coronary artery disease in the SES group. The 1-year target lesion revascularization (5.6% vs 4.8%, p = 0.68) and target vessel revascularization (5.6% vs 7.6%, p = 0.33) rates showed no significant differences between the EES and SES groups. Overall major adverse cardiovascular events occurred in 9.1% of the EES- and 8.6% of SES-treated patients (p = 0.83). This similar major adverse cardiovascular events rate remained after adjustment. The rate of stent thrombosis was 0% in the EES group and 1.2% in the SES group (p = 0.17). In conclusion, EESs demonstrated comparable clinical outcomes to those of SESs in small vessel interventions. The absence of stent thrombosis among patients treated with EESs suggests a good safety profile for this second-generation drug-eluting stent, which should be carefully studied in a larger series of patients with small vessel disease.
authors: Division of Cardiology, MedStar Washington Hospital Center, Washington, DC, USA.
authors: Hironori
authors: H
authors: Kitabata
authors: Joshua P
authors: JP
authors: Loh
authors: Gabriel L
authors: GL
authors: Sardi
authors: Salem
authors: S
authors: Badr
authors: Danny
authors: D
authors: Dvir
authors: Israel M
authors: IM
authors: Barbash
authors: Lakshmana K
authors: LK
authors: Pendyala
authors: Sa'ar
authors: S
authors: Minha
authors: Rebecca
authors: R
authors: Torguson
authors: Fang
authors: F
authors: Chen
authors: Lowell F
authors: LF
authors: Satler
authors: William O
authors: WO
authors: Suddath
authors: Kenneth M
authors: KM
authors: Kent
authors: Augusto D
authors: AD
authors: Pichard
authors: Ron
authors: R
authors: Waksman
mesh_terms: D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000401:mortality; D054855:Drug-Eluting Stents; D023381:Endpoint Determination; D000068338:Everolimus; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D015996:Survival Rate; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus; D020123:Sirolimus