• Jong-Young Lee, Duk-Woo Park, Sung-Cheol Yun, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Myeong-Ki Hong, Seong-Wook Park, and Seung-Jung Park.
• Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
• J. Am. Coll. Cardiol. 2009 Aug 25; 54 (9): 853-9.

ObjectivesThe aim of this study was to evaluate long-term clinical outcomes after implantation of sirolimus-eluting stents (SES) or paclitaxel-eluting stents (PES) among patients with unprotected left main coronary artery (LMCA) disease.BackgroundThere have been few comparisons of long-term outcomes among currently available drug-eluting stents (DES) for the treatment of LMCA disease.MethodsA total of 858 consecutive patients with unprotected LMCA stenosis were treated with SES (n = 669) or PES (n = 189) between May 2003 and June 2006. Primary outcome was the composite of death, myocardial infarction (MI), or target vessel revascularization (TVR).ResultsBaseline clinical and angiographic characteristics were similar in the 2 groups. During 3 years of follow-up, the adjusted risk of primary composite outcome was similar among the groups (SES vs. PES: 25.8% vs. 25.7%, hazard ratio [HR]: 0.95, 95% confidence interval [CI]: 0.64 to 1.41, p = 0.79). The 2 groups also showed a comparable adjusted rate of each component of outcome: death (9.1% vs. 11.0%, HR: 0.92, 95% CI: 0.47 to 1.80, p = 0.82), MI (8.1% vs. 8.0%, HR: 0.80, 95% CI: 0.43 to 1.48, p = 0.47), and TVR (12.1% vs. 10.6%, HR: 1.10, 95% CI: 0.53 to 2.29, p = 0.81). The 3-year rates of definite or probable stent thrombosis were 0.6% in the SES group and 1.6% in the PES group (adjusted p = 0.18).ConclusionsIn consecutive patients with unprotected LMCA disease undergoing DES implantation, SES and PES showed similar long-term clinical outcomes in terms of death, MI, repeat revascularization, and stent thrombosis.2009 by the American College of Cardiology Foundation

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