Randomized prospective comparison of everolimus-eluting vs. Sirolimus-eluting stents in patients undergoing percutaneous coronary intervention ― 3-year clinical outcomes of the EXCELLENT randomized trial

Kyung Woo Park, Tae Min Rhee, Hyun Jae Kang, Bon Kwon Koo, Hyeon Cheol Gwon, Jung Han Yoon, Do-Sun Lim, In Ho Chae, Kyoo Rok Han, Taehoon Ahn, Myung Ho Jeong, Dong Woon Jeon, Yang Soo Jang, Hyo Soo Kim

Research output: Contribution to journalArticle

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Abstract

Background: Everolimus-eluting stents (EES) have equivalent short-term angiographic and clinical outcomes to sirolimus-eluting stents (SES), but EES may be superior to SES with regard to long-term clinical safety. We report the 3-year clinical outcomes of EES and SES from the prospective EXCELLENT Randomized Trial (NCT00698607). Methods and Results: We randomly assigned 1,443 patients undergoing percutaneous coronary intervention 3:1 to receive EES and SES, respectively. We investigated endpoints including target lesion failure (TLF) and individual clinical outcomes including stent thrombosis (ST) at 3 years. For EES and SES, the TLF rate was 4.82% and 4.12% (risk ratio [RR], 1.16, 95% CI: 0.65–2.06, P=0.62), respectively. Results were similar in other efficacy endpoints including target lesion revascularization. For safety endpoints, rate of all-cause death was significantly lower for EES (1.67%) than SES (3.57%; RR, 0.46; 95% CI: 0.23–0.94, P=0.03), while the incidence of cardiac death or myocardial infarction was numerically lower in EES. On 1-year landmark analysis, rates of all-cause death and major adverse cardiovascular events were significantly lower for EES than SES. Definite or probable ST was numerically 3-fold higher for SES (1.37%) compared with EES (0.46%). Conclusions: EES and SES had similar efficacy with regard to 3-year outcomes in the EXCELLENT trial, while delayed safety events all trended to favor EES.

Original languageEnglish
Pages (from-to)1566-1574
Number of pages9
JournalCirculation Journal
Volume82
Issue number6
DOIs
Publication statusPublished - 2018 Jan 1

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Sirolimus
Percutaneous Coronary Intervention
Stents
Everolimus
Safety
Cause of Death
Thrombosis
Odds Ratio

Keywords

  • Everolimus
  • Percutaneous coronary intervention
  • Sirolimus
  • Stent

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Randomized prospective comparison of everolimus-eluting vs. Sirolimus-eluting stents in patients undergoing percutaneous coronary intervention ― 3-year clinical outcomes of the EXCELLENT randomized trial. / Park, Kyung Woo; Rhee, Tae Min; Kang, Hyun Jae; Koo, Bon Kwon; Gwon, Hyeon Cheol; Yoon, Jung Han; Lim, Do-Sun; Chae, In Ho; Han, Kyoo Rok; Ahn, Taehoon; Jeong, Myung Ho; Jeon, Dong Woon; Jang, Yang Soo; Kim, Hyo Soo.

In: Circulation Journal, Vol. 82, No. 6, 01.01.2018, p. 1566-1574.

Research output: Contribution to journalArticle

Park, Kyung Woo ; Rhee, Tae Min ; Kang, Hyun Jae ; Koo, Bon Kwon ; Gwon, Hyeon Cheol ; Yoon, Jung Han ; Lim, Do-Sun ; Chae, In Ho ; Han, Kyoo Rok ; Ahn, Taehoon ; Jeong, Myung Ho ; Jeon, Dong Woon ; Jang, Yang Soo ; Kim, Hyo Soo. / Randomized prospective comparison of everolimus-eluting vs. Sirolimus-eluting stents in patients undergoing percutaneous coronary intervention ― 3-year clinical outcomes of the EXCELLENT randomized trial. In: Circulation Journal. 2018 ; Vol. 82, No. 6. pp. 1566-1574.
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abstract = "Background: Everolimus-eluting stents (EES) have equivalent short-term angiographic and clinical outcomes to sirolimus-eluting stents (SES), but EES may be superior to SES with regard to long-term clinical safety. We report the 3-year clinical outcomes of EES and SES from the prospective EXCELLENT Randomized Trial (NCT00698607). Methods and Results: We randomly assigned 1,443 patients undergoing percutaneous coronary intervention 3:1 to receive EES and SES, respectively. We investigated endpoints including target lesion failure (TLF) and individual clinical outcomes including stent thrombosis (ST) at 3 years. For EES and SES, the TLF rate was 4.82{\%} and 4.12{\%} (risk ratio [RR], 1.16, 95{\%} CI: 0.65–2.06, P=0.62), respectively. Results were similar in other efficacy endpoints including target lesion revascularization. For safety endpoints, rate of all-cause death was significantly lower for EES (1.67{\%}) than SES (3.57{\%}; RR, 0.46; 95{\%} CI: 0.23–0.94, P=0.03), while the incidence of cardiac death or myocardial infarction was numerically lower in EES. On 1-year landmark analysis, rates of all-cause death and major adverse cardiovascular events were significantly lower for EES than SES. Definite or probable ST was numerically 3-fold higher for SES (1.37{\%}) compared with EES (0.46{\%}). Conclusions: EES and SES had similar efficacy with regard to 3-year outcomes in the EXCELLENT trial, while delayed safety events all trended to favor EES.",
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T1 - Randomized prospective comparison of everolimus-eluting vs. Sirolimus-eluting stents in patients undergoing percutaneous coronary intervention ― 3-year clinical outcomes of the EXCELLENT randomized trial

AU - Park, Kyung Woo

AU - Rhee, Tae Min

AU - Kang, Hyun Jae

AU - Koo, Bon Kwon

AU - Gwon, Hyeon Cheol

AU - Yoon, Jung Han

AU - Lim, Do-Sun

AU - Chae, In Ho

AU - Han, Kyoo Rok

AU - Ahn, Taehoon

AU - Jeong, Myung Ho

AU - Jeon, Dong Woon

AU - Jang, Yang Soo

AU - Kim, Hyo Soo

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Everolimus-eluting stents (EES) have equivalent short-term angiographic and clinical outcomes to sirolimus-eluting stents (SES), but EES may be superior to SES with regard to long-term clinical safety. We report the 3-year clinical outcomes of EES and SES from the prospective EXCELLENT Randomized Trial (NCT00698607). Methods and Results: We randomly assigned 1,443 patients undergoing percutaneous coronary intervention 3:1 to receive EES and SES, respectively. We investigated endpoints including target lesion failure (TLF) and individual clinical outcomes including stent thrombosis (ST) at 3 years. For EES and SES, the TLF rate was 4.82% and 4.12% (risk ratio [RR], 1.16, 95% CI: 0.65–2.06, P=0.62), respectively. Results were similar in other efficacy endpoints including target lesion revascularization. For safety endpoints, rate of all-cause death was significantly lower for EES (1.67%) than SES (3.57%; RR, 0.46; 95% CI: 0.23–0.94, P=0.03), while the incidence of cardiac death or myocardial infarction was numerically lower in EES. On 1-year landmark analysis, rates of all-cause death and major adverse cardiovascular events were significantly lower for EES than SES. Definite or probable ST was numerically 3-fold higher for SES (1.37%) compared with EES (0.46%). Conclusions: EES and SES had similar efficacy with regard to 3-year outcomes in the EXCELLENT trial, while delayed safety events all trended to favor EES.

AB - Background: Everolimus-eluting stents (EES) have equivalent short-term angiographic and clinical outcomes to sirolimus-eluting stents (SES), but EES may be superior to SES with regard to long-term clinical safety. We report the 3-year clinical outcomes of EES and SES from the prospective EXCELLENT Randomized Trial (NCT00698607). Methods and Results: We randomly assigned 1,443 patients undergoing percutaneous coronary intervention 3:1 to receive EES and SES, respectively. We investigated endpoints including target lesion failure (TLF) and individual clinical outcomes including stent thrombosis (ST) at 3 years. For EES and SES, the TLF rate was 4.82% and 4.12% (risk ratio [RR], 1.16, 95% CI: 0.65–2.06, P=0.62), respectively. Results were similar in other efficacy endpoints including target lesion revascularization. For safety endpoints, rate of all-cause death was significantly lower for EES (1.67%) than SES (3.57%; RR, 0.46; 95% CI: 0.23–0.94, P=0.03), while the incidence of cardiac death or myocardial infarction was numerically lower in EES. On 1-year landmark analysis, rates of all-cause death and major adverse cardiovascular events were significantly lower for EES than SES. Definite or probable ST was numerically 3-fold higher for SES (1.37%) compared with EES (0.46%). Conclusions: EES and SES had similar efficacy with regard to 3-year outcomes in the EXCELLENT trial, while delayed safety events all trended to favor EES.

KW - Everolimus

KW - Percutaneous coronary intervention

KW - Sirolimus

KW - Stent

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