Impact of Target Lesion and Nontarget Lesion Cardiac Events on 5-Year Clinical Outcomes After Sirolimus-Eluting or Bare-Metal Stenting

Riya Chacko, Meredith Mulhearn, Victor Novack, Lena Novack, Laura Mauri, Sidney A. Cohen, Jeffrey Moses, Martin B. Leon, Donald E. Cutlip

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


Objectives: We sought to compare patient-oriented outcomes related to target vessel or nontarget vessel events for sirolimus-eluting stents (SES) versus bare-metal stents. Background: SES significantly reduce restenosis but the influence of reduced restenosis on overall patient-oriented outcome has not been reported. Methods: The study population included 1,057 patients randomized in the SIRIUS (Sirolimus-Eluting Stent in De Novo Native Coronary Lesions) study and followed clinically for 5 years. The primary end point was a composite of all-cause mortality, any myocardial infarction, or any repeat revascularization. In secondary analyses, myocardial infarction and repeat revascularization events attributed to the target vessel or a nontarget vessel were compared by stent type. Results: Patients with an SES were more likely to be free from the primary composite end point at 5 years (60.4% vs. 47.8%, p < 0.001) chiefly due to a sustained reduction in target lesion revascularization for SES (cumulative incidence: 12.5% vs. 28.8%, p < 0.001). There was no difference in the cumulative incidence of myocardial infarction or revascularization attributed to remote segments of the target vessel. Events attributed to the nontarget vessel were frequent and not different for SES versus bare-metal stents (25.7% vs. 25.8%). Conclusions: The benefit of SES over bare-metal stents for reduced target lesion revascularization is maintained for 5 years. Remote coronary segments of the target vessel and nontarget vessel remain an important cause of future adverse events despite sustained restenosis benefit.

Original languageEnglish
Pages (from-to)498-503
Number of pages6
JournalJACC: Cardiovascular Interventions
Issue number6
StatePublished - 1 Jun 2009
Externally publishedYes


  • atherosclerosis
  • restenosis
  • stent

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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