Risk Factors for Restenosis after Percutaneous Coronary Intervention with Sirolimus- and Paclitaxel-eluting Stents

To identify risk factors for restenosis after percutaneous coronary intervention with sirolimus (SES)- or paclitaxel (PES)-eluting stents. The clinical outcomes of 894 patients treated with either SES (n = 462) or PES (n = 432) between January 2005 and January 2010 were evaluated. Multivariate logistic regression analysis showed that long ( > 20mm)(odds ratio [OR], 1.87; 95% confidence interval [CI], 1.07∼3.33; P = 0.03) or bent (angle > 45°) lesions (OR, 2.57; 95% CI, 1.47∼4.49; P < 0.01) were independent risk factors for restenosis with SES, and that hemodialysis (OR, 7.61; 95% CI, 2.78∼20.85; P < 0.01) and long (OR, 2.63; 95% CI, 1.18∼5.84; P = 0.02) or bent lesions (OR, 3.47; 95% CI, 1.65∼7.27; P < 0.01) were independent risk factors for target lesion revascularization (TLR) with SES. In contrast, no independent risk factors for restenosis and TLR were found for lesions treated with PES. The rate of TLR was significantly higher in patients on hemodialysis or in those with long lesions in the SES group (hemodialysis, 30.4% vs. 11.1%, P = 0.02; long lesions, 13.2% vs. 4.4%, P < 0.01; for SES vs. PES, respectively). Rates of restenosis and TLR were significantly higher in patients with bent lesions in the SES group (restenosis, 30.8% vs. 15.6%, P < 0.01; TLR, 20.0% vs. 5.8%, P < 0.01; for SES and PES, respectively). Most clinical studies have described better angiographic results for SES compared to PES. However, PES might result in better clinical outcomes than SES for patients on hemodialysis or for those with long or bent lesions.