Rationale and design of a randomized clinical comparison of everolimus-eluting (Xience v/Promus) and sirolimus-eluting (cypher select+) coronary stents in unselected patients with coronary heart disease

Cardiology. 2010;116(2):73-8. doi: 10.1159/000315136. Epub 2010 Jun 3.

Abstract

Background: The sirolimus-eluting stent has demonstrated the least amount of late lumen loss among previously released drug-eluting stents, but its safety and efficacy has not been compared head-to-head with the everolimus-eluting stent.

Method: The Scandinavian Organization for Randomized Trials with Clinical Outcome (SORT OUT) IV trial was designed as a prospective, multi-center, open-label, all-comer, two-arm, randomized, non-inferiority study comparing the everolimus-eluting stent with the sirolimus-eluting stent in the treatment of atherosclerotic coronary artery lesions. Based on a non-inferiority design, power calculations estimated a needed enrolment of 2,678 patients. The primary endpoint is a composite of cardiac death, myocardial infarction, and stent thrombosis or target vessel revascularization after 9 months. Data on clinical events and mortality for all randomized patients will be obtained from national databases at 9 months. No clinical follow-up examination is scheduled.

Conclusion: The SORT OUT IV trial will directly compare clinically relevant differences in efficacy and safety in two drug-eluting stents: a first-generation sirolimus-eluting stent versus a second-generation everolimus-eluting stent. The study makes use of clinical endpoints routinely collected in computerized healthcare registries, allowing complete follow-up of a large, well-defined population without scheduled angiographic examinations.

Trial registration: ClinicalTrials.gov NCT00552877.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Angioplasty, Balloon, Coronary*
  • Coronary Disease / therapy*
  • Drug-Eluting Stents*
  • Everolimus
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Research Design
  • Sample Size
  • Sirolimus / administration & dosage*
  • Sirolimus / analogs & derivatives*

Substances

  • Immunosuppressive Agents
  • Everolimus
  • Sirolimus

Associated data

  • ClinicalTrials.gov/NCT00552877