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Sirolimus-eluting stent versus paclitaxel-eluting stent for patients with long coronary artery disease

Young-Hak Kim1, Seong-Wook Park, Seung-Whan Lee

  • 1Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Circulation
|October 25, 2006
PubMed

Insights

Sirolimus-eluting stents (SES) significantly reduced restenosis and revascularization needs in long coronary lesions compared to paclitaxel-eluting stents (PES). This finding offers improved outcomes for patients undergoing coronary interventions for complex lesions.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Biomaterials Science

Background:

  • Coronary interventions for long lesions have suboptimal outcomes.
  • Drug-eluting stents aim to improve these outcomes.
  • Sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) are commonly used.

Purpose of the Study:

  • To compare the efficacy of SES versus PES in treating long native coronary artery lesions.
  • To evaluate restenosis rates and the need for revascularization.

Main Methods:

  • A randomized, multicenter, prospective study involving 500 patients.
  • Patients received either SES or PES for long coronary lesions (>= 25 mm).
  • Primary endpoint was in-segment restenosis at 6-month follow-up angiography.

Main Results:

  • SES demonstrated significantly lower in-segment binary restenosis rates (3.3% vs. 14.6%, P<0.001) compared to PES.
  • In-stent late lumen loss was significantly lower with SES (0.09 mm vs. 0.45 mm, P<0.001).
  • SES group showed a reduced rate of target-lesion revascularization at 9 months (2.4% vs. 7.2%, P=0.012).

Conclusions:

  • SES implantation is superior to PES for long native coronary artery lesions.
  • SES reduces angiographic restenosis and the need for target-lesion revascularization.
  • No significant difference in death or myocardial infarction rates between the groups.
Abstract

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