Abstract 2151: Long-Term Outcome in Patients Treated with Sirolimus Eluting Stents in Complex Coronary Artery Lesions. Analysis of 3-year Results of the Randomized SCANDSTENT Trial

Abstract

Background - The long-term outcome of patients with complex coronary artery lesions treated with drug-eluting stents is unknown. This study evaluated the 3-year clinical outcome of patients randomized in the SCANDSTENT study to have sirolimus-eluting stents (SES) or bare metal stents (BMS) implanted in their complex lesions. Methods and Results - We randomly assigned 322 patients with symptomatic coronary artery disease and either a total coronary occlusion, a lesion located in a bifurcation, in an ostial or in an angulated segment of the coronary artery to have SES or BMS implanted. At 3 years, major adverse cardiac events had occurred in 24 patients (15%) in the SES group and in 59 patients (37%) in the BMS group ( P <0.001). Four versus 2 patients suffered a cardiac death (NS), and 5 versus 1 died of a non-cardiac disease (NS). Six patients in the SES group versus 15 patients in the BMS group suffered a myocardial infarction ( P <0.05), and target lesion revascularization was performed in 8 patients (4.9%) versus 53 patients (33.8%), respectively ( P <0.001); of these 4 in the SES versus 7 in the BMS group was performed between 1 and 3 years after the index treatment (NS). According to revised definitions, stent thrombosis occurred in 5 patients (3.1%) in the SES group and in 7 patients (4.4%) in the BMS group (NS); very late stent thromboses were observed in 4 versus 1 patient. Conclusions - A continued benefit was observed out to 3 years after implantation of SES in patients with complex coronary artery lesions. Late adverse events occurred less frequently in the SES group, and stent thromboses occurred rarely after 1 year.