title: Everolimus- versus sirolimus-eluting stents for the treatment of unprotected left main coronary artery stenosis (results from the EXCELLENT registry).
abstract: BACKGROUND
  Data concerning the results of 2nd generation DES in the treatment of unprotected left main coronary artery (ULMCA) stenosis are limited. The aim of this study was to evaluate the efficacy and safety of stenting with everolimus- (EES) with sirolimus-eluting stent (SES) for the treatment of ULMCA stenosis in the "real world" setting.
  
  
  METHODS
  In this multi-center all-comer registry, a total of 275 patients with ULMCA stenosis were analyzed; 160 receiving EES and 115 receiving SES. The primary endpoint was major adverse cardiac events (MACE), defined as death, myocardial infarction, and ischemia-driven target vessel revascularization at 1 year.
  
  
  RESULTS
  Baseline characteristics were similar between the two stent groups. At 1 year, the rate of MACE was comparable between the two groups (7.5% for EES vs. 13.9% for SES, HR: 0.55 [0.26-1.17], p = 0.117). However, after multivariable or propensity score adjustment, the risk of MACE was significantly lower for EES compared with that for SES (multivariable adjusted HR: 0.42 [0.19-0.92], p = 0.030; propensity score-adjusted HR: 0.43 [0.20-0.95], p = 0.037). These results were mainly driven from the numerically lower rate of repeat revascularization in the EES group (2.5% for EES vs. 7.0% for SES, p = 0.096). As for hard endpoint (death or myocardial infarction) and stent thrombosis, no differences were found between the 2 groups.
  
  
  CONCLUSIONS
  In a large cohort of patients receiving ULMCA stenting, the MACE rate was numerically lower in the EES compared with that in the SES (statistically significant only after adjustment), which was mainly driven by significantly lower rates of repeat revascularization.
authors.affiliation: Seoul National University Hospital, Seoul, South Korea.
authors.forename: Kyung Woo
authors.initials: KW
authors.lastname: Park
authors.forename: Woo-Hyun
authors.initials: WH
authors.lastname: Lim
authors.forename: Hyo-Suk
authors.initials: HS
authors.lastname: Ahn
authors.forename: Si-Hyuck
authors.initials: SH
authors.lastname: Kang
authors.forename: Jung-Kyu
authors.initials: JK
authors.lastname: Han
authors.forename: Sang Eun
authors.initials: SE
authors.lastname: Lee
authors.forename: Jang-Hyun
authors.initials: JH
authors.lastname: Cho
authors.forename: Hyeon-Cheol
authors.initials: HC
authors.lastname: Gwon
authors.forename: Sung Yoon
authors.initials: SY
authors.lastname: Lee
authors.forename: Jae-Young
authors.initials: JY
authors.lastname: Rhew
authors.forename: Wan
authors.initials: W
authors.lastname: Kim
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Chae
authors.forename: Hyo-Soo
authors.initials: HS
authors.lastname: Kim
mesh_terms: D023921:Coronary Stenosis / Q000188:drug therapy* / Q000601:surgery*; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D020123:Sirolimus / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000068338:Everolimus; D020123:Sirolimus
keywords: Drug-eluting stent; Everolimus-eluting stent; Left main coronary artery disease; Sirolimus-eluting stent