Aims It has been demonstrated that, in comparison with bare-metal stents (BMS), sirolimus-eluting stents (SES) reduce restenosis after the percutaneus revascularization of small coronary arteries, but the long-term clinical outcomes of this treatment have not yet been investigated.Methods and resultsThe long-term SES-SMART clinical study was a multicentre, prospective, randomized, single-blind study of 257 patients receiving a SES or BMS in a small coronary artery, who were evaluated at discharge, 30 days, 8 and 24 months after stenting. The clinical endpoint of the study was a 24 months composite of major adverse cardiac and cerebrovascular events, which included death, non-fatal myocardial infarction, ischaemia-driven target lesion revascularization (TLR), and cerebrovascular accident. The 24 months follow-up was completed by 254 patients (98.8). The use of SES was associated with a significantly lower incidence of the clinical endpoint (12.6 vs. 33.1; HR 0.30, 95 CI: 0.17-0.55; P <0.0001), which was not only due to a reduction in TLR (7.9 vs. 29.9; HR 0.30, 95 CI: 0.16-0.59; P <0.0001), but also to a reduction in myocardial infarction (1.6 vs. 10.2; HR 0.09, 95 CI: 0.01-0.66; P = 0.018).ConclusionIn comparison with BMS, the use of SES in the percutaneous revascularization of small coronary arteries is associated with improved clinical outcomes after 2 years follow-up.
- Myocardial infarction
- Small coronary arteries
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine