Three-year outcomes following sirolimus- versus paclitaxel-eluting stent implantation in an unselected population with coronary artery disease: The REWARDS Registry




Background


Safety concerns have necessitated the assessment of longer-term outcomes of patients treated with drug-eluting stents (DES). This study aimed to examine whether there is a difference in long-term outcomes between sirolimus-eluting (SES) and paclitaxel-eluting stents (PES).




Methods


The study population consisted of all comers who were treated exclusively with either SES or PES. Comparison was made between those receiving SES ( n =2459) vs. PES ( n =1139) at 3 years’ post-stent implantation. The primary end point was major adverse cardiac events (MACE) which included death, Q-wave myocardial infarction (QWMI), target vessel revascularization (TVR), and cumulative incidence of stent thrombosis (ST).




Methods


The study population consisted of all comers who were treated exclusively with either SES or PES. Comparison was made between those receiving SES ( n =2459) vs. PES ( n =1139) at 3 years’ post-stent implantation. The primary end point was major adverse cardiac events (MACE) which included death, Q-wave myocardial infarction (QWMI), target vessel revascularization (TVR), and cumulative incidence of stent thrombosis (ST).




Results


There was no difference between the SES and PES for the overall MACE rates at 3 years. There was no difference in TVR (SES=22.9%, PES=19.9%; P =.06), but there was a difference in unadjusted rates of death (SES=15.7%, PES=19.0%; P =.02) and QWMI (SES=0.8%, PES=2.1%; P =.003). After adjusting for baseline differences, including a composite analysis of death, QWMI, and ST, there was no significant difference in MACE or in any of its comprising end points ( Table 1 ). The incidence of ST was higher in the SES group (SES=2.2%, PES=1.6%; P =.22).


Nov 16, 2017 | Posted by in CARDIOLOGY | Comments Off on Three-year outcomes following sirolimus- versus paclitaxel-eluting stent implantation in an unselected population with coronary artery disease: The REWARDS Registry

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