Five-year outcomes after first- and second-generation drug-eluting stent implantation in all patients undergoing percutaneous coronary intervention.
BACKGROUND
Use of the everolimus-eluting stent (EES) instead of the sirolimus-eluting stent (SES) has been shown to improve clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) out to 3 years. However, it is not known whether the differences in efficacy and safety outcomes remain constant throughout 5 years.


METHODS
This was a retrospective, non-randomized, observational study. We followed 1460 consecutive patients undergoing PCI in our institutions from April 2005 to March 2012. There were 718 cases in patients with SES (SES group) and 742 with EES (EES group). Ten-month angiographic follow-up results and 5-year clinical follow-up outcomes were compared between the EES and SES groups. The primary outcome of this study was major adverse cardiac events (MACE), defined as the composite of cardiac death, recurrent myocardial infarction (MI), target vessel revascularization (TVR), and stent thrombosis (ST).


RESULTS
At 5 years, the rates of target lesion revascularization (TLR), TVR, recurrent MI and ST were significantly lower in the EES group compared to the SES group (TLR: 4.6% vs. 8.2%, p<0.05; TVR: 5.0% vs. 9.0%, p<0.05; recurrent MI: 1.5% vs. 4.4%, p<0.05; ST: 1.2% vs. 3.9%, p<0.05). Thus, MACE were significantly lesser in the EES group compared to the SES group (8.8% vs. 12.8%, p=0.006).


CONCLUSIONS
EES improved clinical outcomes compared to SES, and specifically, was associated with reductions in TVR, ST, and recurrent MI out to 5 years.
['Yano|Hideki|H|', 'Horinaka|Shigeo|S|', 'Watahiki|Manami|M|', 'Watanabe|Tomoko|T|', 'Ishimitsu|Toshihiko|T|']
D000368:Aged D054855:Drug-Eluting Stents D000068338:Everolimus D005260:Female D005500:Follow-Up Studies D006801:Humans D008297:Male D008875:Middle Aged D062645:Percutaneous Coronary Intervention D011183:Postoperative Complications D012189:Retrospective Studies D020123:Sirolimus D013927:Thrombosis D013997:Time Factors D016896:Treatment Outcome
Everolimus-eluting stent Sirolimus-eluting stent Major adverse cardiac events Stent thrombosis