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outcome of EES in comparison with SES. Although the incidence of ST is rare, ranging from 0.5% to 3% at around 3 years, it is of paramount importance to survey its incidence because it induces catastrophic events once it occurs. In this regard, accumulation of long-term follow-up data from many prospective trials is necessary to objectively judge this rare event associated with each new-generation DES. The safety data reported by Park et al are basically in accordance with the findings of previous trials,2,3 thus reinforcing the data from a meta-analysis4 that demonstrated that the incidence of EES thrombosis is lower than that of bare-metal stent (BMS) and 1st-generation DES thrombosis. The biocompatible and thromboresistant profile of fluorinated polymer on EES5 is considered to play a key role in reducing thrombosis. Morino et al have also recently demonstrated early vascular healing in EES by using serial optical coherence tomography assessment in primary percutaneous coronary intervention (PCI) for acute MI.6 The new-generation DES available in Japan at T he sirolimus-eluting stent (SES: Cypher, Cordis Corp.) and paclitaxel-eluting stent (PES: TAXUS, Boston Scientific), the so-called 1st-generation drugeluting stents (DES), dramatically reduced the incidence of in-stent restenosis. As their use became widespread worldwide, new enemies emerged at long-term follow-up such as late restenosis, very late thrombosis, delayed arterial healing, and neoatherosclerosis. Thus, follow-up of patients with newer generation DES is imperative for long-term evaluation of the incidence of such adverse phenomena. In this issue of the Journal, Park et al1 report the 3-year clinical outcomes of the everolimus-eluting stent (EES: Xience, Abbott Vascular; Promus, Boston Scientific) in comparison with those for the SES in the prospective EXCELLENT randomized trial. From 1 to 3 years, death, myocardial infarction (MI), and major adverse cardiac events were significantly less prevalent in the EES group than in the SES group. Furthermore, the prevalence of definite or probable stent thrombosis (ST) in the SES arm (1.37%) was 3-fold higher that in the EES arm (0.46%), although the difference did not reach statistical significance (P=0.08). In fact, this is not the first study to investigate the long-term Article p ????

Are All New-Generation Drug-Eluting Stents Equal? ― Long-Term Follow-up Is Necessary ―