Comparison of Long-term outcomes between everolimus-eluting and sirolimus-eluting stents in small vessels

Hironori Kitabata, Joshua P. Loh, Gabriel L. Sardi, Salem Badr, Danny Dvir, Israel M. Barbash, Lakshmana K. Pendyala, Sa'Ar Minha, Rebecca Torguson, Fang Chen, Lowell F. Satler, William O. Suddath, Kenneth M. Kent, Augusto D. Pichard, Ron Waksman

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)973-978
Number of pages6
JournalAmerican Journal of Cardiology
Volume111
Issue number7
DOIs
StatePublished - 1 Apr 2013
Externally publishedYes

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