Midterm angiographic outcomes with sirolimus- and everolimus-eluting stents for small vessels in diabetic patients: propensity-score-matched comparisons in three different vessel diameters.

Abstract

We conducted propensity-score-matched comparisons of midterm angiographic follow-up outcomes of sirolimus- versus everolimus-eluting stents (SES, EES) after elective placements for de novo coronary stenosis in small vessels (SV) in patients with diabetes mellitus (DM), because the angiographic efficacy of EES over SES for those cohorts remained unclear. The study was a non-randomized, retrospective, lesion-based, multicenter study, examining lesions followed up angiographically within 550 days, extracted from the unified database of 6 institutes. The endpoint (binary restenosis) was defined as the percentage of subjects having >50% diameter stenosis at follow-up. Propensity-score-matched analyses were conducted in 3 different vessel-size cohorts, defined by a preprocedural reference diameter (RD) <2.10, <2.35, and <2.60 mm, yielding group sizes of n = 107, 183, and 312 baseline-adjusted lesions in each of the 2 stent arms. The frequency of binary restenosis decreased significantly with increasing vessel size, at 16.8, 12.6, and 12.2%, in the SES group. However, it remained almost the same across vessel-size groups in the EES group (8.0, 6.0, and 7.5%). The p values for the significance of the differences in binary restenosis between EES and SES in each vessel size increased with the decrease in vessel size [p = 0.002, 0.040, and 0.063 (the last still nearly significant)]. Thus, in patients with DM, EES showed increasingly superior efficacy over SES for SV stenosis as the vessel size became smaller, i.e., the risk for binary restenosis became greater.

• Authors: Kenichiro Suzuki, Tetsuya Ishikawa, Makoto Mutoh, Hiroshi Sakamoto, Takeyuki Kubota, Takayuki Ogawa, Chikara Mori, Koichi Hashimoto, Kimiaki Komukai, Michihiro Yoshimura, a Multicenter Registry in The Jikei University
• Journal: Cardiovascular intervention and therapeutics (Cardiovasc Interv Ther) Vol. 33 Issue 3 Pg. 205-216 (Jul 2018) ISSN: 1868-4297 [Electronic] Japan
• PMID: 28349417 (Publication Type: Comparative Study, Journal Article, Multicenter Study)

Chemical References

• Immunosuppressive Agents
• Everolimus
• Sirolimus

Topics

• Aged
• Coronary Angiography (methods)
• Coronary Stenosis (diagnostic imaging, surgery)
• Coronary Vessels (diagnostic imaging, pathology, surgery)
• Diabetes Mellitus (surgery)
• Diabetic Angiopathies (surgery)
• Drug-Eluting Stents (adverse effects)
• Everolimus (administration & dosage, adverse effects)
• Female
• Follow-Up Studies
• Humans
• Immunosuppressive Agents (administration & dosage, adverse effects)
• Male
• Middle Aged
• Percutaneous Coronary Intervention (adverse effects, methods)
• Propensity Score
• Retrospective Studies
• Sirolimus (administration & dosage, adverse effects)
• Treatment Outcome