Long-term Clinical Outcomes Of Everolimus Eluting-stents Compared To Sirolimus-Eluting Stents For The Treatment Of Coronary Heart Disease

Objective:Evaluation of the long-term safety and efficacy of secondgeneration everolimus-eluting stents(EES)compared to first-generation sirolimus-eluting stents(SES)for the treatment of coronary heart disease.Background:Most of study about drug-eluting stents for the treatment of coronary heart disease are short and rare,There are limited long-term data comparing everolimus-eluting stents( EES) to sirolimus-eluting stents(SES).Methods : 463 patients with percutaneous intracoronary arterial stenting were selected from the second affiliated hospital of Chongqing Medical University from May,2009 to December,2011.The patients were divided into everolimus group(EES,282 cases) and sirolimus group(SES,181 cases).The telephone follow-up, clinical follow-up or case history taking were adopted to acquire the follow-up data. The primary endpoint was referred to major adverse cardiac events(MACE). The secondary endpoint events were in-stent thrombosis and all-cause mortality.The research also conducted follow-up on usage condition of aspirin, clopidogrel,gastrointestinal side-effect and haemorrhagic activity.Results: The clinical Baseline characteristics were mostly similar; SES group was characterized by slightly high CHD family history. The coronary lesion characteristics and target vessels condition were basically similar. The balloon pressure in EES group was higher than that in SES group. The stent diameter in SES group was larger than that in EES group. With(54.4±6.1) months follow-up, there was no statistical difference between two groups in MACE occurrence rate after 30 days, one year, two years, three years, four years and 4.5 years of the operation(P>0.05). There was no statistical difference between two groups in stent thrombosis incidence after 30 days, one year, two years, three years, four years and 4.5 years of the operation(P>0.05). There was no statistical difference between two groups concerning all-cause mortality after 30 days, one year, two years, three years, four years and 4.5 years of the operation(P>0.05). The usage condition of aspirin and clopidogrel was basically similar. The aspirin usage rate in EES group was lower than that in SES group in the second and third years. And the aspirin usage rate in EES group was higher than that in SES group in the fourth year. The clopidogrel usage rate in EES group was higher than that in SES group in the second and third year.The number of patients with gastrointestinal side-effect and with minor bleeding after surgery in EES group was obviously higher than that in SES group. There was no significant statistical difference between two groups in the severe bleeding after the operation.Conclusions: This research indicated through 4-5 years follow-up that the EES or SES implanted in patients with coronary heart disease showed similar long-term clinical efficacy with better safety and effectiveness.