J Korean Med Sci.  2013 Mar;28(3):396-401. 10.3346/jkms.2013.28.3.396.

Seven-Year Clinical Outcomes of Sirolimus-Eluting Stent Versus Bare-Metal Stent: A Matched Analysis From A Real World, Single Center Registry

• Kim U
• Park JS
• Lee SH
• Shin DG
• Kim YJ

• KMID: 1786937
• DOI: http://doi.org/10.3346/jkms.2013.28.3.396

Abstract

The aim of this study is to compare clinical outcomes for seven years, between sirolimus-eluting stent (SES) and bare metal stent (BMS). During the BMS and drug-eluting stent (DES) transition period (from April 2002 to April 2004), 434 consecutive patients with 482 lesions underwent percutaneous coronary intervention, using BMS or SES. Using propensity score matching, 186 patients with BMS and 166 patients with SES were selected. Seven year clinical outcomes of major adverse cardiac events (MACE), such as cardiac death, myocardial infarction (MI) and ischemia-driven target vessel revascularization (TVR), and angiographic definite stent thrombosis (ST) were compared. At one-year follow up, patients with SES showed significantly lower MACE (9.1% in BMS vs 3.0% in SES, P = 0.024). However, cumulative MACE for 7 yr was not significantly different between two groups (24.7% in BMS vs 17.4% in SES, P = 0.155). There was no significant difference in MI, TVR, death and ST. The TVR were gradually increased from 1 to 7 yr in SES, on the contrary to that of BMS. In conclusion, although SES showed better clinical outcomes in the early period after implantation, it did not show significant benefits in the long-term follow up, compared with that of BMS.

Keyword

Drug-Eluting Stents; Bare-Metal Stents; Long-term

MeSH Terms

Aged
Angioplasty, Balloon, Coronary/adverse effects/*methods
Coronary Angiography
Coronary Stenosis/mortality/radiography/*therapy
Databases, Factual
*Drug-Eluting Stents
Female
Follow-Up Studies
Humans
Ischemia/etiology
Kaplan-Meier Estimate
Male
Middle Aged
Myocardial Infarction/etiology
Myocardial Revascularization
Registries
Sirolimus/*therapeutic use
*Stents
Thrombosis/etiology
Sirolimus

Figure

• 

  Fig. 1 Kaplan-Meier curves for major adverse cardiac events (MACE) during each time periods. Panel A shows no differences in MACE for 7 yr between two groups (P = 0.344). However, the rate of MACE was higher in bare-metal stent (BMS) than Sirolimus-eluting stent (SES) for 1 yr after stent implantation (Panel B, P = 0.026). After 1 yr, the rate of MACE was similar between two groups (Panel C, P = 0.754).

• 

  Fig. 2 Kaplan-Meier curves for ischemia-driven target vessel revascularization (TVR) during each time periods. Panel A shows no difference in TVR between bare-metal stent (BMS) and Sirolimus-eluting stent (SES, P = 0.710). However, there are significant differences during 1 yr after stent implantation (8% in BMS vs 2% in SES, P = 0.020, Panel B). After 1 yr, the rate of TVR was not different between two groups (Panel C, P = 0.144).

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