Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
Cardiovascular Intervention
Randomized Prospective Comparison of Everolimus-Eluting vs. Sirolimus-Eluting Stents in Patients Undergoing Percutaneous Coronary Intervention ― 3-Year Clinical Outcomes of the EXCELLENT Randomized Trial ―
Kyung Woo ParkTae-Min RheeHyun-Jae KangBon-Kwon KooHyeon-Cheol GwonJung-Han YoonDo-Sun LimIn-Ho ChaeKyoo-Rok HanTaehoon AhnMyung-Ho JeongDong-Woon JeonYang-Soo JangHyo-Soo Kim
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2018 Volume 82 Issue 6 Pages 1566-1574

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Abstract

Background:Everolimus-eluting stents (EES) have equivalent short-term angiographic and clinical outcomes to sirolimus-eluting stents (SES), but EES may be superior to SES with regard to long-term clinical safety. We report the 3-year clinical outcomes of EES and SES from the prospective EXCELLENT Randomized Trial (NCT00698607).

Methods and Results:We randomly assigned 1,443 patients undergoing percutaneous coronary intervention 3:1 to receive EES and SES, respectively. We investigated endpoints including target lesion failure (TLF) and individual clinical outcomes including stent thrombosis (ST) at 3 years. For EES and SES, the TLF rate was 4.82% and 4.12% (risk ratio [RR], 1.16, 95% CI: 0.65–2.06, P=0.62), respectively. Results were similar in other efficacy endpoints including target lesion revascularization. For safety endpoints, rate of all-cause death was significantly lower for EES (1.67%) than SES (3.57%; RR, 0.46; 95% CI: 0.23–0.94, P=0.03), while the incidence of cardiac death or myocardial infarction was numerically lower in EES. On 1-year landmark analysis, rates of all-cause death and major adverse cardiovascular events were significantly lower for EES than SES. Definite or probable ST was numerically 3-fold higher for SES (1.37%) compared with EES (0.46%).

Conclusions:EES and SES had similar efficacy with regard to 3-year outcomes in the EXCELLENT trial, while delayed safety events all trended to favor EES.

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© 2018 THE JAPANESE CIRCULATION SOCIETY
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