Background: Drug-eluting stent (DES) has been proven its efficacy in randomized trial. But the effectiveness and/or compassion between sirolimus-eluting stents (SES) and paclitaxel-eluting stens (PES) in unselected patients treated in the daily practice are largely in controversy. Therefore, we investigate the outcomes of 2 types of drug-eluting stents.
Methods and Result: In daily practice of coronary intervention in Seoul National University Hospital (SNUH), SES and PES implantation have been used as the default strategy as part of the SNUH-DES registry since March, 2003. Consecutive patients (n=477) treated with SES and/or PES were compared. Lesions deployed with SES (n=402), PES (n=199) were analyzed. There was no significant difference in lesion characteristics (type C lesion: 46.0 in SES vs 44.7 % in PES), in percent stenosis at baseline, and at postprocedure. At six-month follow-up, angiographic binary resnosis rate, TLR, TVR and MACE were slightly higher in PES groups. No subacute stent thrombosis occurred in the SES group, and 2 in the PES group. In long lesion subset (>36mm), in trend, SES was slightly better than PES. In small vessel (<2.75mm) subset, SES showed better outcomes than PES. In bifurcating lesions, stenting of both branches (4 %) or stenting of the main branch with provisional kissing balloon of the side branch (96%), overally SES is slightly better except side branch restenosis. Intriguingly, no significant restenosis was observed at overlapped site of SES/PES (2 cases).[See table]
Conclusion: Unselected utilization of 2 type drug-eluting stents in practice is generally safe and effective in reducing both repeated revascularization and major adverse cardiac events. In comparison between 2 stents, it unraveled that SES showed better outcomes compared with PES.