Intracoronary DrugEluting Stenting to Abrogate Restenosis in Small Arteries ISARSMART

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Intracoronary Drug-Eluting Stenting to Abrogate
Restenosis in Small Arteries(ISAR-SMART)

• Adapted fromMehilli et al. Eur Heart J
  200627260-266

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ISAR-SMART
Objective

• To compare the efficacy of sirolimus-eluting and
  paclitaxel-eluting stents in patients with small
  coronary vessels, angina pectoris, and
  significant stenosis in a native coronary vessel

Mehilli et al. Eur Heart J 200627260-266
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ISAR-SMART
Study Design
Mehilli et al. Eur Heart J 200627260-266
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ISAR-SMART
Results I Baseline Demographics
Mehilli et al. Eur Heart J 200627260-266
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ISAR-SMART
Results II Late Loss
Plt0.001
Plt0.001
Mehilli et al. Eur Heart J 200627260-266
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ISAR-SMART
Results III Restenosis (gt50 Binary)
P0.047
P0.04
Mehilli et al. Eur Heart J 200627260-266
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ISAR-SMART
Results IV Target Lesion Revascularization
P0.008
Mehilli et al. Eur Heart J 200627260-266
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ISAR-SMART
Results V Restenosis by Vessel Size
P0.02
P0.66
P0.75
Mehilli et al. Eur Heart J 200627260-266
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ISAR-SMART
Conclusions

• Efficacy of the sirolimus-eluting stent is
  superior to the paclitaxel-eluting stent with
  respect to late lumen loss (primary endpoint)
• Randomization to sirolimus-eluting stents
  resulted in lower rates of angiographic
  restenosis and target lesion revascularization
  (secondary endpoints)
• Increased binary restenosis for
  paclitaxel-eluting stents was largely driven in
  vessels lt2.24 mm
• Both stents are relatively safe and efficacious
  in patients with small arteries

Mehilli et al. Eur Heart J 200627260-266