Everolimus-Eluting vs Sirolimus-Eluting Stents in Coronary Artery Disease

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None of the patients who received everolimus-eluting stents had very late stent thrombosis.
None of the patients who received everolimus-eluting stents had very late stent thrombosis.

WASHINGTON, DC — Everolimus-eluting stents were superior in efficacy and safety compared with sirolimus-eluting stents after a 5-year follow-up, according to research presented at the 66th Annual Scientific Session & Expo of the American College of Cardiology.

Researchers from Shizuoka, Japan evaluated the long-term safety and efficacy of the 2 stents in patients with coronary artery disease (N=1202). A total of 404 patients were implanted with everolimus-eluting stents and 798 patients were implanted with sirolimus-eluting stents.

The primary outcomes were ischemia-driven target lesion revascularization (TLR), definite stent thrombosis, and major adverse cardiac events (MACE).

TLR was performed in 3.7% of patients in the everolimus-eluting stent group and 5.9% in the sirolimus-eluting stent group within 5 years.

Although the TLR and MACE rates did not differ significantly between the 2 stent groups within the first year, the cumulative incidence of MACE was 6.7% in the everolimus-eluting stent group and 11.2% in the sirolimus-eluting stent group (P =.013). After 1 year, patients in the everolimus-eluting stent group had a lower rate of TLR (1.3%) compared with the sirolimus-eluting stent group (3.4%; P =.045). Similarly, the 1 year cumulative incidence of MACE was lower in the everolimus-eluting stent group (3.7%) vs the sirolimus-eluting stent group (6.4%; P =.067).

Definite stent thrombosis rates were also lower in the patients who received everolimus-eluting stents vs patients who received the sirolimus-eluting stents (0.2% vs 1.5%; P =.047), and there were no cases of very late stent thrombosis in the everolimus-eluting stent group vs 1.1% in the sirolimus-eluting stent group (P =.043).

The researchers noted that the lack of very late stent thrombosis largely attributed to the overall positive outcomes in the group that received the everolimus-eluting stents.

Reference

Sugiyama H, Murata K, Nawada R, Onodera T. Superiority of everolimus-eluting stents over sirolimus-eluting stents in long-term safety and efficacy. Abstract 1286-181. Presented at: the 66th Annual Scientific Session & Expo of the American College of Cardiology. March 17-19, 2017; Washington, DC.

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