Comparison of long-term clinical outcomes in multivessel coronary artery disease patients treated either with bioresoarbable polymer sirolimus-eluting stent or permanent polymer everolimus-eluting stent. 5-year results of the CENTURY II randomized clinical trial

Objectives:To assess the long-term safety and efficacy of a sirolimus-eluting stent withbioresorbable polymer (BP-SES; Ultimaster), in comparison to a benchmark everolimus-eluting, permanent polymer stent (PP-EES; Xience), in a prespecified subgroup of patientswith multivessel coronary artery disease (MVD) enrolled in the CENTURY II trial.Background:The use of coronary stenting in high-risk subgroups, like MVD patients,is rising. The clinical evidence, including long-term comparative analysis of the effi-cacy and safety benefits of different new-generation drug eluting stents, however,remains insufficient.Methods:Among 1,119 patients (intention-to-treat) enrolled in the CENTURY IIprospective, randomized, single-blind, multicenter trial, a prespecified subgroup of456 MVD patients were allocated by stratified randomization to treatment withBP-SES (n= 225) or PP-EES (n= 231). The previously reported primary endpoint ofthis study was freedom from target lesion failure (TLF: a composite of cardiac death,target vessel-related myocardial infarction [MI] and clinically-indicated target lesionrevascularization) at 9 months.Results:In this MVD substudy, baseline patient, lesion and procedure characteristicswere similar between the treatment arms. At 1 and 5 years, both BP-SES and PP-EES dsplayed low and comparable rates of TLF (5.3 vs. 7.8%;p= .29 and 10.2 vs. 13.4%;p= .29), and definite or probable stent thrombosis (0.4 vs. 1.3%;p= .33 and 0.9vs. 1.7%;p= .43), respectively. Composite endpoint of cardiac death and MI, andpatient-oriented composite endpoint of any death, MI, and coronary revasculariza-tions were also similar.Conclusions:These results confirm good long-term safety and efficacy of the studiedbioresorbable polymer stent in this high-risk patient population.