Overlapping sirolimus-eluting stents result in a lower overall major adverse cardiac event rate and significantly fewer myocardial infarctions than bare stents for complex patients with conditions such as diabetes, multiple-vessel disease, small arteries, or hypertension, according to a presentation at the annual meeting of the European Society of Cardiology.

Professor Martin Rothman, Barts and London NHS Trust Hospital, United Kingdom, reviewed an analysis of overlapping stent procedures from four randomized clinical studies. Approximately 25 percent of coronary stent procedures involve overlapping two or more stents in order to fully cover a lesion inside an artery.

The analysis examined the following trials: SIRIUS (SIRolImUS-coated Bx Velocity balloon-expandable stent in the treatment of patients with de novo coronary artery lesions), E-SIRIUS (European version of SIRIUS), DIRECT (DIRECT stenting using the Sirolimus-eluting Bx Velocity stent), and SVELTE (Study in Patients with De Novo Coronary Artery Lesions in Small Vessels Treated with the CYPHERR Stent) trial.

The overall conclusion of the analysis suggests there is a significant difference with the CYPHERR Stent versus bare metal stents in such overlapping stent cases.

Specifically, the analysis showed that overlapping sirolimus-eluting (CYPHERR) stents resulted in a lower overall major adverse cardiac event rate than the bare metal control arm. The cardiac event rate was identified as all-cause mortality, myocardial infarction, repeat revascularization, and non Q-wave myocardial infarction rate at one year post procedure.

The analysis showed patients who received overlapping sirolimus-eluting stents had a significantly lower incidence of cardiac events and non Q-wave myocardial infarctions than patients treated in the bare metal control arm at one year (7.4 percent versus 31.5 percent; p<0.001), (1.5 percent versus 4.6 percent; p=0.03) respectively.

"The number of patients with complex lesions is leading to an increased interest in overlapping stent data among cardiologists," said Professor Rothman. "The results of this analysis once again underscore the safety of the CYPHERR Stent in treating complex cases."