To compare 10-year outcomes after implantation of sirolimus-eluting stents (SES) versus paclitaxel-eluting stents (PES) for left main coronary artery (LMCA) stenosis. Very long-term outcome data of patients with LMCA disease treated with drug-eluting stents (DES) have not been well described. In 10-year extended follow-up of the MAINCOMPARE registry, we evaluated 778 patients with unprotected LMCA stenosis who were treated with SES (n = 607) or PES (n = 171) between January 2000 and June 2006. The primary composite outcome (a composite of death, myocardial infarction [MI] or target-vessel revascularization [TVR]) was compared with an inverse-probability-of-treatment-weighting (IPTW) adjustment. Clinical events have linearly accumulated over 10 years. At 10 years, there were no significant differences between SES and PES in the observed rates of the primary composite outcome (42.0% vs. 47.4%; hazard ratio [HR] 0.85; 95% confidence interval [CI] 0.66–1.10), and definite stent thrombosis (ST) (1.9% vs. 1.8%; HR 1.02, 95% CI 0.28–3.64). In the IPTW-adjusted analyses, there were no significant differences between SES and PES in the risks for the primary composite outcome (HR 0.89, 95% CI 0.65–1.14) or definite ST (adjusted HR 1.05, 95% CI 0.29–3.90). In patients who underwent DES implantation, high overall adverse clinical event rates (with a linearly increasing event rate over time) were observed during extended follow-up. At 10 years, there were no measurable differences in outcomes between patients treated with SES vs. PES for LMCA disease. The incidence of stent thrombosis was quite low and comparable between the groups.

中文翻译：

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左主干冠状动脉疾病患者早期西罗莫司与紫杉醇洗脱支架的十年结果

比较植入西罗莫司洗脱支架 (SES) 与紫杉醇洗脱支架 (PES) 治疗左冠状动脉主干 (LMCA) 狭窄后的 10 年结果。用药物洗脱支架 (DES) 治疗的 LMCA 疾病患者的非常长期的结果数据尚未得到很好的描述。在 MAINCOMPARE 注册的 10 年延长随访中，我们评估了 778 名接受 SES ( n  = 607) 或 PES ( n = 171）在 2000 年 1 月至 2006 年 6 月之间。主要复合结果（死亡、心肌梗死 [MI] 或靶血管血运重建 [TVR] 的复合结果）与治疗加权逆概率 (IPTW) 进行比较调整。临床事件线性累积超过 10 年。在 10 年时，SES 和 PES 之间在主要复合结果的观察率上没有显着差异（42.0% 对 47.4%；风险比 [HR] 0.85；95% 置信区间 [CI] 0.66-1.10），并且明确的支架血栓形成 (ST)（1.9% 对 1.8%；HR 1.02，95% CI 0.28–3.64）。在 IPTW 调整后的分析中，SES 和 PES 之间在主要复合结局（HR 0.89，95% CI 0.65-1.14）或明确 ST（调整后 HR 1.05，95% CI 0.29-3.90）的风险方面没有显着差异. 在接受 DES 植入的患者中，在延长的随访期间观察到较高的总体不良临床事件发生率（事件发生率随时间线性增加）。在 10 年时，接受 SES 治疗的患者与接受 PES 治疗的 LMCA 疾病患者的结果没有可测量的差异。支架内血栓形成的发生率非常低，并且两组之间具有可比性。