title: Very late outcomes of drug-eluting stents coated with biodegradable polymers: insights from the 5-year follow-up of the randomized PAINT trial.
abstract: BACKGROUND
  Few studies have examined the very long-term outcomes after implantation of drug-eluting stents (DES) coated with biodegradable polymers (BP). This report presents the 5-year clinical follow-up of patients treated with BP-DES in the randomized PAINT trial.
  
  
  METHODS
  The PAINT study is a prospective, multicenter randomized controlled trial that allocated 274 patients for treatment with two BP-DES formulations [paclitaxel-eluting stents (PES) or sirolimus-eluting stents (SES)] or bare metal stents (BMS) in a 1:2:2 ratio, respectively. The primary end-point of this sub-study was defined as the composite of the major cardiac adverse events (MACE) cardiac death, myocardial infarction (MI) or ischemia-driven target vessel revascularization (TVR) at 5 years.
  
  
  RESULTS
  The 5-year MACE rates were different among the groups: 35.3%, 22.5% and 16.9% for BMS, PES and SES, respectively (P<0.05 for both DES vs. bare stent comparisons). The primary end-point was mainly driven by TVR: 31.8%, 14.1% and 12.2% for bare stents, PES and SES, respectively (P<0.05 for both DES vs. bare stent comparisons). The incidence of stent thrombosis (ST) was null for BMS during the entire follow-up. There was no definite or probable ST in the SES group after the second year, while one patient (1.0%) presented with a definite ST episode in the PES group between 4 and 5 years.
  
  
  CONCLUSIONS
  The tested biodegradable-polymer coated stents releasing either paclitaxel or sirolimus, compared with same bare metal platform, sustained their effectiveness in reducing combined major adverse cardiac events and re-intervention without an increase in ST during 5 years of follow-up.
authors.affiliation: 1 Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil ; 2 Hospital Universitário Cassiano Antonio de Moraes, Vitória, Brazil ; 3 Hospital Santa Marcelina, São Paulo, Brazil ; 4 Natal Hospital Center, Natal, Brazil ; 5 Hospital Meridional, Vitória, Brazil ; 6 Federal University of São Paulo (UNIFESP-EPM), São Paulo, Brazil ; 7 Hospital Universitário Walter Cantidio, Fortaleza, Brazil ; 8 Hospital São Lucas - PUC-RS, Porto Alegre, Brazil ; 9 Rede D'Or de Hospitais, Rio de Janeiro, Brazil ; 10 Hospital Biocor, Belo Horizonte, Brazil ; 11 São Camilo Hospital, São Paulo, Brazil.
authors.forename: Julio F
authors.initials: JF
authors.lastname: Marchini
authors.affiliation: 1 Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil ; 2 Hospital Universitário Cassiano Antonio de Moraes, Vitória, Brazil ; 3 Hospital Santa Marcelina, São Paulo, Brazil ; 4 Natal Hospital Center, Natal, Brazil ; 5 Hospital Meridional, Vitória, Brazil ; 6 Federal University of São Paulo (UNIFESP-EPM), São Paulo, Brazil ; 7 Hospital Universitário Walter Cantidio, Fortaleza, Brazil ; 8 Hospital São Lucas - PUC-RS, Porto Alegre, Brazil ; 9 Rede D'Or de Hospitais, Rio de Janeiro, Brazil ; 10 Hospital Biocor, Belo Horizonte, Brazil ; 11 São Camilo Hospital, São Paulo, Brazil.
authors.forename: Wilton F
authors.initials: WF
authors.lastname: Gomes
authors.affiliation: 1 Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil ; 2 Hospital Universitário Cassiano Antonio de Moraes, Vitória, Brazil ; 3 Hospital Santa Marcelina, São Paulo, Brazil ; 4 Natal Hospital Center, Natal, Brazil ; 5 Hospital Meridional, Vitória, Brazil ; 6 Federal University of São Paulo (UNIFESP-EPM), São Paulo, Brazil ; 7 Hospital Universitário Walter Cantidio, Fortaleza, Brazil ; 8 Hospital São Lucas - PUC-RS, Porto Alegre, Brazil ; 9 Rede D'Or de Hospitais, Rio de Janeiro, Brazil ; 10 Hospital Biocor, Belo Horizonte, Brazil ; 11 São Camilo Hospital, São Paulo, Brazil.
authors.forename: Bruno
authors.initials: B
authors.lastname: Moulin
authors.affiliation: 1 Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil ; 2 Hospital Universitário Cassiano Antonio de Moraes, Vitória, Brazil ; 3 Hospital Santa Marcelina, São Paulo, Brazil ; 4 Natal Hospital Center, Natal, Brazil ; 5 Hospital Meridional, Vitória, Brazil ; 6 Federal University of São Paulo (UNIFESP-EPM), São Paulo, Brazil ; 7 Hospital Universitário Walter Cantidio, Fortaleza, Brazil ; 8 Hospital São Lucas - PUC-RS, Porto Alegre, Brazil ; 9 Rede D'Or de Hospitais, Rio de Janeiro, Brazil ; 10 Hospital Biocor, Belo Horizonte, Brazil ; 11 São Camilo Hospital, São Paulo, Brazil.
authors.forename: Marco A
authors.initials: MA
authors.lastname: Perin
authors.affiliation: 1 Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil ; 2 Hospital Universitário Cassiano Antonio de Moraes, Vitória, Brazil ; 3 Hospital Santa Marcelina, São Paulo, Brazil ; 4 Natal Hospital Center, Natal, Brazil ; 5 Hospital Meridional, Vitória, Brazil ; 6 Federal University of São Paulo (UNIFESP-EPM), São Paulo, Brazil ; 7 Hospital Universitário Walter Cantidio, Fortaleza, Brazil ; 8 Hospital São Lucas - PUC-RS, Porto Alegre, Brazil ; 9 Rede D'Or de Hospitais, Rio de Janeiro, Brazil ; 10 Hospital Biocor, Belo Horizonte, Brazil ; 11 São Camilo Hospital, São Paulo, Brazil.
authors.forename: Ludmilla A R R
authors.initials: LA
authors.lastname: Oliveira
authors.affiliation: 1 Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil ; 2 Hospital Universitário Cassiano Antonio de Moraes, Vitória, Brazil ; 3 Hospital Santa Marcelina, São Paulo, Brazil ; 4 Natal Hospital Center, Natal, Brazil ; 5 Hospital Meridional, Vitória, Brazil ; 6 Federal University of São Paulo (UNIFESP-EPM), São Paulo, Brazil ; 7 Hospital Universitário Walter Cantidio, Fortaleza, Brazil ; 8 Hospital São Lucas - PUC-RS, Porto Alegre, Brazil ; 9 Rede D'Or de Hospitais, Rio de Janeiro, Brazil ; 10 Hospital Biocor, Belo Horizonte, Brazil ; 11 São Camilo Hospital, São Paulo, Brazil.
authors.forename: J Airton
authors.initials: JA
authors.lastname: Arruda
authors.affiliation: 1 Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil ; 2 Hospital Universitário Cassiano Antonio de Moraes, Vitória, Brazil ; 3 Hospital Santa Marcelina, São Paulo, Brazil ; 4 Natal Hospital Center, Natal, Brazil ; 5 Hospital Meridional, Vitória, Brazil ; 6 Federal University of São Paulo (UNIFESP-EPM), São Paulo, Brazil ; 7 Hospital Universitário Walter Cantidio, Fortaleza, Brazil ; 8 Hospital São Lucas - PUC-RS, Porto Alegre, Brazil ; 9 Rede D'Or de Hospitais, Rio de Janeiro, Brazil ; 10 Hospital Biocor, Belo Horizonte, Brazil ; 11 São Camilo Hospital, São Paulo, Brazil.
authors.forename: Valter C
authors.initials: VC
authors.lastname: Lima
authors.affiliation: 1 Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil ; 2 Hospital Universitário Cassiano Antonio de Moraes, Vitória, Brazil ; 3 Hospital Santa Marcelina, São Paulo, Brazil ; 4 Natal Hospital Center, Natal, Brazil ; 5 Hospital Meridional, Vitória, Brazil ; 6 Federal University of São Paulo (UNIFESP-EPM), São Paulo, Brazil ; 7 Hospital Universitário Walter Cantidio, Fortaleza, Brazil ; 8 Hospital São Lucas - PUC-RS, Porto Alegre, Brazil ; 9 Rede D'Or de Hospitais, Rio de Janeiro, Brazil ; 10 Hospital Biocor, Belo Horizonte, Brazil ; 11 São Camilo Hospital, São Paulo, Brazil.
authors.forename: Antonio A G
authors.initials: AA
authors.lastname: Lima
authors.affiliation: 1 Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil ; 2 Hospital Universitário Cassiano Antonio de Moraes, Vitória, Brazil ; 3 Hospital Santa Marcelina, São Paulo, Brazil ; 4 Natal Hospital Center, Natal, Brazil ; 5 Hospital Meridional, Vitória, Brazil ; 6 Federal University of São Paulo (UNIFESP-EPM), São Paulo, Brazil ; 7 Hospital Universitário Walter Cantidio, Fortaleza, Brazil ; 8 Hospital São Lucas - PUC-RS, Porto Alegre, Brazil ; 9 Rede D'Or de Hospitais, Rio de Janeiro, Brazil ; 10 Hospital Biocor, Belo Horizonte, Brazil ; 11 São Camilo Hospital, São Paulo, Brazil.
authors.forename: Paulo R A
authors.initials: PR
authors.lastname: Caramori
authors.affiliation: 1 Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil ; 2 Hospital Universitário Cassiano Antonio de Moraes, Vitória, Brazil ; 3 Hospital Santa Marcelina, São Paulo, Brazil ; 4 Natal Hospital Center, Natal, Brazil ; 5 Hospital Meridional, Vitória, Brazil ; 6 Federal University of São Paulo (UNIFESP-EPM), São Paulo, Brazil ; 7 Hospital Universitário Walter Cantidio, Fortaleza, Brazil ; 8 Hospital São Lucas - PUC-RS, Porto Alegre, Brazil ; 9 Rede D'Or de Hospitais, Rio de Janeiro, Brazil ; 10 Hospital Biocor, Belo Horizonte, Brazil ; 11 São Camilo Hospital, São Paulo, Brazil.
authors.forename: Cesar R
authors.initials: CR
authors.lastname: Medeiros
authors.affiliation: 1 Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil ; 2 Hospital Universitário Cassiano Antonio de Moraes, Vitória, Brazil ; 3 Hospital Santa Marcelina, São Paulo, Brazil ; 4 Natal Hospital Center, Natal, Brazil ; 5 Hospital Meridional, Vitória, Brazil ; 6 Federal University of São Paulo (UNIFESP-EPM), São Paulo, Brazil ; 7 Hospital Universitário Walter Cantidio, Fortaleza, Brazil ; 8 Hospital São Lucas - PUC-RS, Porto Alegre, Brazil ; 9 Rede D'Or de Hospitais, Rio de Janeiro, Brazil ; 10 Hospital Biocor, Belo Horizonte, Brazil ; 11 São Camilo Hospital, São Paulo, Brazil.
authors.forename: Mauricio R
authors.initials: MR
authors.lastname: Barbosa
authors.affiliation: 1 Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil ; 2 Hospital Universitário Cassiano Antonio de Moraes, Vitória, Brazil ; 3 Hospital Santa Marcelina, São Paulo, Brazil ; 4 Natal Hospital Center, Natal, Brazil ; 5 Hospital Meridional, Vitória, Brazil ; 6 Federal University of São Paulo (UNIFESP-EPM), São Paulo, Brazil ; 7 Hospital Universitário Walter Cantidio, Fortaleza, Brazil ; 8 Hospital São Lucas - PUC-RS, Porto Alegre, Brazil ; 9 Rede D'Or de Hospitais, Rio de Janeiro, Brazil ; 10 Hospital Biocor, Belo Horizonte, Brazil ; 11 São Camilo Hospital, São Paulo, Brazil.
authors.forename: Fabio S
authors.initials: FS
authors.lastname: Brito
authors.affiliation: 1 Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil ; 2 Hospital Universitário Cassiano Antonio de Moraes, Vitória, Brazil ; 3 Hospital Santa Marcelina, São Paulo, Brazil ; 4 Natal Hospital Center, Natal, Brazil ; 5 Hospital Meridional, Vitória, Brazil ; 6 Federal University of São Paulo (UNIFESP-EPM), São Paulo, Brazil ; 7 Hospital Universitário Walter Cantidio, Fortaleza, Brazil ; 8 Hospital São Lucas - PUC-RS, Porto Alegre, Brazil ; 9 Rede D'Or de Hospitais, Rio de Janeiro, Brazil ; 10 Hospital Biocor, Belo Horizonte, Brazil ; 11 São Camilo Hospital, São Paulo, Brazil.
authors.forename: Expedito E
authors.initials: EE
authors.lastname: Ribeiro
authors.affiliation: 1 Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil ; 2 Hospital Universitário Cassiano Antonio de Moraes, Vitória, Brazil ; 3 Hospital Santa Marcelina, São Paulo, Brazil ; 4 Natal Hospital Center, Natal, Brazil ; 5 Hospital Meridional, Vitória, Brazil ; 6 Federal University of São Paulo (UNIFESP-EPM), São Paulo, Brazil ; 7 Hospital Universitário Walter Cantidio, Fortaleza, Brazil ; 8 Hospital São Lucas - PUC-RS, Porto Alegre, Brazil ; 9 Rede D'Or de Hospitais, Rio de Janeiro, Brazil ; 10 Hospital Biocor, Belo Horizonte, Brazil ; 11 São Camilo Hospital, São Paulo, Brazil.
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Lemos
keywords: Drug-eluting stents (DES); coronary restenosis; randomized clinical trial