Drug-Eluting versus Bare-Metal Stents in Large Coronary Arteries

Patients with coronary artery disease undergoing percutaneous coronary intervention were assigned to receive sirolimus-eluting, everolimus-eluting, or bare-metal stents. At 2 years, there was no significant between-group difference in the rate of death from cardiac causes or nonfatal myocardial infarction. First-generation drug-eluting coronary-artery stents (which release sirolimus or paclitaxel) have been shown to reduce the risk of restenosis after percutaneous coronary intervention, as compared with bare-metal stents. However, these drug-eluting stents have also been associated with a risk of late stent thrombosis, which in turn may be associated with death from cardiac causes or nonfatal myocardial infarction. 1 , 2 For patients with stenoses in large coronary arteries, requiring stents of 3.0 mm or more in diameter, the benefits of the use of drug-eluting stents have been considered especially uncertain for two reasons. First, in these patients, the benefit of reducing the . . .