Sirolimus versus paclitaxel-eluting stents in small coronary vessels: long-term outcomes from a single-center registry

Abstract

Objective: Several studies showed that small vessel diameter is a determinant of increased risk of adverse events after stenting. The efficacy of different drug-eluting stent types implanted in small vessels has still not been established. The aim of the present observational study was to compare long-term clinical outcomes after sirolimus-eluting stent (SES) or paclitaxel-eluting stent (PES) implantation in lesions located in small coronary vessels.

Methods: For the purpose of this analysis patients undergoing SES or PES implantation in vessels with diameter 2.5 mm or less, from May 2002 to December 2006, were included. Long-term rates of major adverse cardiac events were evaluated and compared between the two groups. Independent predictors of major adverse cardiac events were also investigated.

Results: A total of 336 patients were included, 225 were treated only with SES and 111 only with PES. During a mean follow-up of 23.3 +/- 12.1 months the major adverse cardiac events rates were 12.8 versus 13.6%, P = 0.98 in SES versus PES groups, respectively. The rates of target lesion revascularization (8.0 versus 6.3%, P = 0.75), mortality (3.5 versus 4.5%, P = 0.88) and myocardial infarction (2.6 versus 4.5%, P = 0.41) were similar between SES and PES, respectively. The overall thrombosis rate was also not significantly different in SES and PES groups (1.3% SES versus 4.5% PES, P = 0.12).

Conclusion: In this study SES and PES provided similar long-term results after treatment of lesions in small vessels. Nevertheless, larger randomized studies are needed to confirm these findings.