In a real-world practice setting, sirolimus-eluting and paclitaxel-eluting coronary stents produce similar results for clinical outcomes including myocardial infarction and death, according to an article in the January 30 issue of the Journal of the American Medical Association.

Anders M. Galloe, MD, of the University of Copenhagen, Denmark, and colleagues compared the efficacy and safety of sirolimus-eluting and paclitaxel-eluting stents in a study designed to reflect everyday clinical practice.

The SORT OUT II trial included 2,098 men and women treated with percutaneous coronary intervention and randomized to sirolimus-eluting (1,065 patients) or paclitaxel-eluting (1,033 patients) stents at five university hospitals in Denmark. The patients were initially treated for ST-segment elevation myocardial infarction (STEMI), non-STEMI or unstable angina, and stable angina.

The proportion of patients experiencing major adverse cardiac events such as cardiac death, myocardial infarction, target lesion revascularization, or target vessel revascularization, were 98 (9.3 percent) for sirolimus-eluting stents and 114 (11.2 percent) for paclitaxel-eluting stents. Stent thrombosis rates were 27 (2.5 percent) for sirolimus-eluting stents and 30 (2.9 percent) for paclitaxel-eluting stents.

"In conclusion, the SORT OUT II trial found no statistical significant differences in the primary or secondary end points between the sirolimus-eluting stent and paclitaxel-eluting stent in everyday clinical practice among patients undergoing PCI for ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction or unstable angina pectoris, and stable angina. The rates of serious adverse events, cardiac death, acute myocardial infarction, and stent thrombosis were low, suggesting that, at least when considering 18 months of follow-up, the use of drug-eluting stents in the general population may be safe," the authors wrote.