Twenty-four months clinical outcomes of sirolimus-eluting stents for the treatment of small coronary arteries: The long-term SES-SMART clinical study

Alberto Menozzi, Emilia Solinas, Paolo Ortolani, Alessandra Repetto, Francesco Saia, Giancarlo Piovaccari, Antonio Manari, Enrico Magagnini, Luigi Vignali, Erminio Bonizzoni, Piera Angelica Merlini, Claudio Cavallini, Diego Ardissino

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)2095-2101
Number of pages7
JournalEuropean Heart Journal
Volume30
Issue number17
DOIs
Publication statusPublished - Sep 2009

Keywords

  • Myocardial infarction
  • Revascularization
  • Sirolimus
  • Small coronary arteries
  • Stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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