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

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

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

TY - JOUR

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.

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U2 - 10.1253/circj.CJ-17-0677

DO - 10.1253/circj.CJ-17-0677

M3 - Article

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VL - 82

SP - 1566

EP - 1574

JO - Circulation Journal

JF - Circulation Journal

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