In-hospital and mid-term clinical outcomes after percutaneous coronary intervention with the use of sirolimus- or paclitaxel-eluting stents.

Background: Drug-eluting stents improved the outcome after percutaneous coronary intervention (PCI), however, there may be significant differences in their safety and efficacy.

Aim: To compare the in-hospital and mid-term clinical outcomes of stenting with sirolimus-eluting stents (SES) versus paclitaxel-eluting stents (PES) for the treatment of coronary artery lesions in our routine practice.

Methods: This study was performed on 1311 consecutive patients treated exclusively either with SES or PES in our hospital between March 2003 and March 2007. Patients with acute myocardial infarction (MI) within the preceding 48 hours were excluded. The data were recorded in our computerised database, and analysed with appropriate statistical methods.

Results: The frequency of angulated segments and proximal segment tortuosity was higher in the PES group (p = 0.001 and p < 0.001, respectively), while ostial and left anterior descending artery lesions were more frequently treated with SES (p < 0.001 and p = 0.022, respectively). The rate of in-hospital non-Q wave MI was higher in the SES vs. PES group (2.2 vs. 0.7%, p = 0.039). In multivariate analysis, the relationship between type of stent and in-hospital non-Q-wave MI became less significant (p = 0.083). During follow-up, 5 patients in the SES vs. 3 in the PES group died (0.7% in each group, p = 0.749). The frequency of major adverse cardiac events (MACE) and target vessel revascularisation (TVR) in the SES vs. PES group was similar (5.5 vs. 3.3%, p = 0.138, and 2.9 vs. 1.6%, p = 0.213, respectively). In multivariate analysis, reference vessel diameter was an independent predictor of both TVR (HR = 0.170, 95% CL 0.034-0.837, p = 0.029) and MACE (HR = 0.333, 95% CL 0.120-0.925, p = 0.035).

Conclusion: During mid-term follow-up, sirolimus-eluting stents and paclitaxel-eluting stents demonstrate similar clinical outcomes.