Author + information
- Hirofumi Sugiyama,
- Koichiro Murata,
- Ryuzo Nawada and
- Tomoya Onodera
Background: Long-term safety and efficacy comparing everolimus-eluting(EES) and sirolimus-eluting stents(SES) in patients with coronary artery disease(CAD) are unknown. In particular, only a few reports showing superiority of EES in very late stent thrombosis and ischemia-driven target lesion revascularization after one year comparing with SES were seen. This study compared five-year outcomes for EES with those for SES in patients with CAD.
Methods: We enrolled 1202 patients, 404 patients in EES and 798 patients in SES group, who received implantation of the stents in our hospital. Five-year clinical follow-up was completed in 1145 patients (95.3%). We evaluated ischemia-driven target lesion revascularization (TLR), definite stent thrombosis and major adverse cardiac events(MACE)(cardiac death, myocardial infarction, TLR and definite stent thrombosis).
Results: Within five years, TLR were performed in 3.7% and 5.9% in EES and SES group(p=NS). The cumulative incidence of MACE were 6.7% in EES and 11.2% in SES group(p=0.013). Within the first year, TLR rate and MACE rate did not differ significantly between the EES and SES group(TLR:2.5% vs 2.6%, p=NS, MACE:3.3% vs 5.3%, p=NS). By landmark analysis after one year, after one year, late TLR rate in EES(1.3%) were lower than in SES group(3.4%)(p=0.045) and the cumulative incidence of MACE in EES(3.7%) tended to be lower than in SES group(6.4%) (p=0.067). Within five years, definite stent thrombosis rate were lower in EES than in SES group(0.2% vs 1.5%, p=0.047). In particular, very late stent thrombosis(VLST) rate were lower in EES than in SES group(0% vs 1.1%, p=0.043).
Conclusions: At five-year follow-up, EES demonstrated superiority in efficacy and safety than SES. The cumulative incidence of overall MACE, late TLR after one year and definite stent thrombosis were lower in EES than in SES patients. The effect was attributable largely to a lower risk of very late definite stent thrombosis.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Coronary Intervention in Interventional Cardiology: Core Concepts
Abstract Category: 21. Interventional Cardiology: Coronary Intervention: Devices
Presentation Number: 1286-181
- 2017 American College of Cardiology Foundation