This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: j.jacc.2005.09.040v1 47/3/507    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Valgimigli, M. Articles by Serruys, P. W. Search for Related Content PubMed PubMed Citation Articles by Valgimigli, M. Articles by Serruys, P. W.

CLINICAL RESEARCH: INTERVENTIONAL CARDIOLOGY

Sirolimus-Eluting Versus Paclitaxel-Eluting Stent Implantation for the Percutaneous Treatment of Left Main Coronary Artery Disease

A Combined RESEARCH and T-SEARCH Long-Term Analysis

Erasmus Medical Center, Thoraxcenter, Rotterdam, the Netherlands

Manuscript received June 7, 2005; accepted September 8, 2005.

^_* Reprint requests and correspondence: Prof. Patrick W. Serruys, Thoraxcenter, Bd-406, Dr Molewaterplein 40, 3015-GD Rotterdam, the Netherlands (Email: p.w.j.c.serruys{at}erasmusmc.nl).

OBJECTIVES: The purpose of this study was to investigate the long-term clinical and angiographic profile of sirolimus-eluting stent (SES) versus paclitaxel-eluting stent (PES) in patients undergoing percutaneous intervention for left main (LM) coronary disease.

BACKGROUND: The long-term clinical and angiographic impact of SES as opposed to PES implantation in this subset of patients is unknown.

METHODS: From April 2002 to March 2004, 110 patients underwent percutaneous intervention for LM stenosis at our institution; 55 patients were treated with SES and 55 with PES. The two groups were well balanced for all baseline characteristics.

RESULTS: At a median follow-up of 660 days (range 428 to 885), the cumulative incidence of major adverse cardiovascular events was similar (25% in the SES group vs. 29%, in the PES group; hazard ratio 0.88 [95% confidence interval 0.43 to 1.82]; p = 0.74), reflecting similarities in both the composite death/myocardial infarction (16% in the SES group and 18% in the PES group) and target vessel revascularization (9% in the SES group and 11% in the PES group). Angiographic in-stent late loss (mm), evaluated in 73% of the SES group and in 77% of the PES group, was 0.32 ± 74 in the main and 0.36 ± 0.59 in the side branch in the SES group vs. 0.46 ± 0.57 (p = 0.36) and 0.52 ± 0.42 (p = 0.41) in the PES group, respectively.

CONCLUSIONS: In consecutive patients undergoing percutaneous LM intervention, PES may perform closely to SES both in terms of angiographic and long-term clinical outcome.

Abbreviations and Acronyms   BMS = bare-metal stent   BR = binary restenosis   CX = left circumflex coronary artery   DES = drug-eluting stent   IVUS = intravascular ultrasound   LAD = left anterior descending coronary artery   LL = late loss   LM = left main coronary artery   MACE = major adverse cardiac events   MI = myocardial infarction   MLD = minimal luminal diameter   PES = paclitaxel-eluting stent   RCA = right coronary artery   SES = sirolimus-eluting stent   TVR = target vessel revascularization

This article has been cited by other articles:

				C. Wu, E. L. Hannan, G. Walford, and D. P. Faxon Utilization and outcomes of unprotected left main coronary artery stenting and coronary artery bypass graft surgery. Ann. Thorac. Surg., October 1, 2008; 86(4): 1153 - 1159. [Abstract] [Full Text] [PDF]

				A. J. White, G. Kedia, J. M. Mirocha, M. S. Lee, J. S. Forrester, W. C. Morales, S. Dohad, S. Kar, L. S. Czer, G. P. Fontana, et al. Comparison of Coronary Artery Bypass Surgery and Percutaneous Drug-Eluting Stent Implantation for Treatment of Left Main Coronary Artery Stenosis J. Am. Coll. Cardiol. Intv., June 1, 2008; 1(3): 236 - 245. [Abstract] [Full Text] [PDF]

				D. Mukherjee and D. J. Moliterno Effectiveness of Drug-Eluting Stents in Real-World Patients JAMA, January 30, 2008; 299(4): 454 - 455. [Full Text] [PDF]

				A. Erglis, I. Narbute, I. Kumsars, S. Jegere, I. Mintale, I. Zakke, U. Strazdins, and A. Saltups A Randomized Comparison of Paclitaxel-Eluting Stents Versus Bare-Metal Stents for Treatment of Unprotected Left Main Coronary Artery Stenosis J. Am. Coll. Cardiol., August 7, 2007; 50(6): 491 - 497. [Abstract] [Full Text] [PDF]

				S. R. Dixon, C. L. Grines, and W. W. O'Neill The Year in Interventional Cardiology J. Am. Coll. Cardiol., July 17, 2007; 50(3): 270 - 285. [Full Text] [PDF]

				A. Chieffo, S. J. Park, M. Valgimigli, Y. H. Kim, J. Daemen, I. Sheiban, A. Truffa, M. Montorfano, F. Airoldi, G. Sangiorgi, et al. Favorable Long-Term Outcome After Drug-Eluting Stent Implantation in Nonbifurcation Lesions That Involve Unprotected Left Main Coronary Artery: A Multicenter Registry Circulation, July 10, 2007; 116(2): 158 - 162. [Abstract] [Full Text] [PDF]

				N. Beohar, C. J. Davidson, K. E. Kip, L. Goodreau, H. A. Vlachos, S. N. Meyers, K. H. Benzuly, J. D. Flaherty, M. J. Ricciardi, C. L. Bennett, et al. Outcomes and Complications Associated With Off-Label and Untested Use of Drug-Eluting Stents JAMA, May 9, 2007; 297(18): 1992 - 2000. [Abstract] [Full Text] [PDF]

				A. N. DeMaria, O. Ben-Yehuda, G. K. Feld, G. S. Ginsburg, B. H. Greenberg, W. Y.W. Lew, J. A.C. Lima, A. S. Maisel, J. Narula, D. J. Sahn, et al. Highlights of the Year in JACC 2006 J. Am. Coll. Cardiol., January 30, 2007; 49(4): 509 - 527. [Full Text] [PDF]

				C. Kimmelstiel Multislice Computed Tomography After Left Main Drug-Eluting Stenting: Are We Putting the CarT Before the Horse? Circulation, August 15, 2006; 114(7): 616 - 619. [Full Text] [PDF]

				D. J. Kereiakes and D. P. Faxon Left Main Coronary Revascularization at the Crossroads Circulation, May 30, 2006; 113(21): 2480 - 2484. [Full Text] [PDF]