Long-term comparison of everolimus-eluting and sirolimus-eluting stents for coronary revascularization

Räber, Lorenz; Jüni, Peter; Nüesch, Eveline; Kalesan, Bindu; Wenaweser, Peter; Moschovitis, Aris; Khattab, Ahmed A; Bahlo, Maryam; Togni, Mario; Cook, Stéphane; Vogel, Rolf; Seiler, Christian; Meier, Bernhard; Windecker, Stephan (2011). Long-term comparison of everolimus-eluting and sirolimus-eluting stents for coronary revascularization. Journal of the American College of Cardiology, 57(21), pp. 2143-2151. New York, N.Y.: Elsevier 10.1016/j.jacc.2011.01.023

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Objectives This study sought to compare the unrestricted use of everolimus-eluting stents (EES) with sirolimus-eluting stents (SES) in patients undergoing percutaneous coronary intervention. Background It is unclear whether there are differences in safety and efficacy between EES and SES during long-term follow-up. Methods Using propensity score matching, clinical outcome was compared among 1,342 propensity score–matched pairs of patients treated with EES and SES. The primary outcome was a composite of death, MI, and target vessel revascularization. Results The median follow-up was 1.5 years with a maximum of 3 years. The primary outcome occurred in 14.9% of EES- and 18.0% of SES-treated patients up to 3 years (hazard ratio [HR]: 0.83, 95% confidence interval [CI]: 0.68 to 1.00, p = 0.056). All-cause mortality (6.0% vs. 6.5%, HR: 0.92, 95% CI: 0.68 to 1.25, p = 0.59) was similar, risks of myocardial infarction (MI) (3.3% vs. 5.0%, HR: 0.62, 95% CI: 0.42 to 0.92, p = 0.017), and target vessel revascularization (7.0% vs. 9.6%, HR: 0.75, 95% CI: 0.57 to 0.99, p = 0.039) were lower with EES than SES. Definite stent thrombosis (ST) (HR: 0.30, 95% CI: 0.12 to 0.75, p = 0.01) was less frequent among patients treated with EES. The reduced rate of MI with EES was explained in part by the lower risk of definite ST and the corresponding decrease in events associated with ST (HR: 0.25, 95% CI: 0.08 to 0.75, p = 0.013). Conclusions The unrestricted use of EES appears to be associated with improved clinical long-term outcome compared with SES. Differences in favor of EES are driven in part by a lower risk of MI associated with ST.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Cardiovascular Engineering (CVE)

UniBE Contributor:

Räber, Lorenz; Nüesch, Eveline; Kalesan, Bindu; Wenaweser, Peter Martin; Moschovitis, Aris; Khattab, Ahmed Aziz; Bahlo, Maryam; Togni, Mario; Cook, Stéphane; Vogel, Rolf; Seiler, Christian; Meier, Bernhard and Windecker, Stephan

ISSN:

0735-1097

Publisher:

Elsevier

Language:

English

Submitter:

Lorenz Räber

Date Deposited:

04 Oct 2013 14:12

Last Modified:

14 Oct 2017 01:21

Publisher DOI:

10.1016/j.jacc.2011.01.023

PubMed ID:

21596229

Web of Science ID:

000290724600005

BORIS DOI:

10.7892/boris.2603

URI:

https://boris.unibe.ch/id/eprint/2603 (FactScience: 205335)

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