Key result
Sirolimus-eluting stents did not significantly reduce cumulative major adverse cardiac events at 7 years compared to bare-metal stents (17.4% vs 24.7%, p=0.155), despite showing early benefits at 1 year.
Why the study?
Does sirolimus-eluting stent implantation reduce long-term major adverse cardiac events compared to bare-metal stent implantation in patients undergoing percutaneous coronary intervention?
Cohort (n=352)
No
Does sirolimus-eluting stent implantation reduce long-term major adverse cardiac events compared to bare-metal stent implantation in patients undergoing percutaneous coronary intervention?
Absolute Event Rate: 17.4% vs 24.7%
p-value: p=0.155
First-generation sirolimus-eluting stents significantly reduce major adverse cardiac events at 1 year compared to bare-metal stents, but this benefit is attenuated over 7 years due to a late catch-up phenomenon in target vessel revascularization.
The aim of this study is to compare clinical outcomes for seven years, between sirolimus-eluting stent (SES) and bare metal stent (BMS). During the BMS and drug-eluting stent (DES) transition period (from April 2002 to April 2004), 434 consecutive patients with 482 lesions underwent percutaneous coronary intervention, using BMS or SES. Using propensity score matching, 186 patients with BMS and 166 patients with SES were selected. Seven year clinical outcomes of major adverse cardiac events (MACE), such as cardiac death, myocardial infarction (MI) and ischemia-driven target vessel revascularization (TVR), and angiographic definite stent thrombosis (ST) were compared. At one-year follow up, patients with SES showed significantly lower MACE (9.1% in BMS vs 3.0% in SES, P = 0.024). However, cumulative MACE for 7 yr was not significantly different between two groups (24.7% in BMS vs 17.4% in SES, P = 0.155). There was no significant difference in MI, TVR, death and ST. The TVR were gradually increased from 1 to 7 yr in SES, on the contrary to that of BMS. In conclusion, although SES showed better clinical outcomes in the early period after implantation, it did not show significant benefits in the long-term follow up, compared with that of BMS.
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Kim et al. (2013) conducted a cohort in Coronary artery disease (n=352). Sirolimus-eluting stent vs. Bare-metal stent was evaluated on Cumulative major adverse cardiac events (MACE) at 7 years (p=0.155). Sirolimus-eluting stents did not significantly reduce cumulative major adverse cardiac events at 7 years compared to bare-metal stents (17.4% vs 24.7%, p=0.155), despite showing early benefits at 1 year.
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