title: Randomized comparison of sirolimus-eluting and everolimus-eluting coronary stents in the treatment of total coronary occlusions: results from the chronic coronary occlusion treated by everolimus-eluting stent randomized trial.
abstract: BACKGROUND
  Patients with coronary total occlusions are at especially high risk for restenosis and new revascularizations. Sirolimus-eluting stents dramatically improved the clinical outcome of this subset of patients in randomized trials, but other drug-eluting stents, mainly the everolimus-eluting stent (currently the most frequently used stent), have not yet been evaluated in patients with coronary total occlusions. The objective was to compare the second-generation everolimus-eluting stent with the first-generation sirolimus-eluting stent in patients with coronary total occlusions.
  
  
  RESULTS
  A total of 207 patients with coronary total occlusions and estimated time since occlusion >2 weeks were randomized to everolimus- or sirolimus-eluting stent. The primary end point was in-stent late loss at 9-month angiographic follow-up (noninferiority trial). Clinical follow-up was performed at 1 and 12 months. In-stent late loss at 9 months was 0.29±0.60 versus 0.13±0.69 mm in patients allocated to sirolimus- and everolimus-eluting stent, respectively. The observed difference in in-stent late loss between both groups was -0.16 mm (95% confidence interval, 0.04 to -0.36 mm; P for noninferiority <0.01). The rate of binary angiographic restenosis was 10.8% and 9.1% in patients allocated to sirolimus- and everolimus-eluting stent, respectively (P=0.709), whereas the rate of vessel reocclusion was 3.2% and 1.1%, respectively (P=0.339). At 12 months, the rate of major adverse events was 15.9% versus 11.1% with sirolimus- and everolimus-eluting stent, respectively (P=0.335), and probable or definitive stent thrombosis occurred in 3.0% and 0.0% of patients, respectively (P=0.075).
  
  
  CONCLUSIONS
  In patients with coronary total occlusions, everolimus-eluting stent is as effective as sirolimus-eluting stent.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT00793221.
authors: Hospital Universitario La Paz, 28046 Madrid, Spain. raulmorenog@terra.es.s
authors: Raul
authors: R
authors: Moreno
authors: Eulogio
authors: E
authors: García
authors: Rui
authors: R
authors: Teles
authors: Jose-Ramon
authors: JR
authors: Rumoroso
authors: Henrique
authors: H
authors: Cyrne Carvalho
authors: Francisco Javier
authors: FJ
authors: Goicolea
authors: José
authors: J
authors: Moreu
authors: Josefa
authors: J
authors: Mauri
authors: Manel
authors: M
authors: Sabaté
authors: Vicente
authors: V
authors: Mainar
authors: Lino
authors: L
authors: Patricio
authors: Mariano
authors: M
authors: Valdés
authors: Felipez
authors: F
authors: Fernández Vázquez
authors: Angel
authors: A
authors: Sánchez-Recalde
authors: Guillermo
authors: G
authors: Galeote
authors: Santiago
authors: S
authors: Jimenez-Valero
authors: Manuel
authors: M
authors: Almeida
authors: Esteban
authors: E
authors: Lopez de Sa
authors: Luis
authors: L
authors: Calvo
authors: Ignacio
authors: I
authors: Plaza
authors: Jose-Luis
authors: JL
authors: Lopez-Sendón
authors: Jose-Luis R
authors: JL
authors: Martín
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D023903:Coronary Restenosis / Q000209:etiology / Q000517:prevention & control*; D054855:Drug-Eluting Stents / Q000706:statistics & numerical data; D000068338:Everolimus; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D009204:Myocardial Revascularization; D011183:Postoperative Complications / Q000517:prevention & control*; D012306:Risk; D020123:Sirolimus / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives*; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000068338:Everolimus; D020123:Sirolimus