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Medline ® Abstract for Reference 73

of 'Use of intracoronary stents for specific coronary lesions'

Twenty-four months clinical outcomes of sirolimus-eluting stents for the treatment of small coronary arteries: the long-term SES-SMART clinical study.
Menozzi A, Solinas E, Ortolani P, Repetto A, Saia F, Piovaccari G, Manari A, Magagnini E, Vignali L, Bonizzoni E, Merlini PA, Cavallini C, Ardissino D, SES-SMART Investigators
Eur Heart J. 2009;30(17):2095. Epub 2009 Jun 9.
AIMS: It has been demonstrated that, in comparison with bare-metal stents (BMS), sirolimus-eluting stents (SES) reduce restenosis after the percutaneous revascularization of small coronary arteries, but the long-term clinical outcomes of this treatment have not yet been investigated.
METHODS AND RESULTS: The 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).
CONCLUSION: In 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.
UnitàOperativa di Cardiologia, Dipartimento Cardio-Polmonare, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy. almenozzi@ao.pr.it