Sirolimus-eluting coronary stents Figure 1 Sirolimus-eluting coronary stent is the most studied of all drug-eluting stents, with data generated from randomized controlled trials and registries. AMI, acute myocardial infarction; CTO, chronic total occlusions; DM, diabetes mellitus; ISR, in-stent restenosis; MVD, multi vessel disease. 1. The rising epidemic of diabetes, more complex lesions (small vessels, more extensive and diffuse disease, multi- vessel disease, total occlusions, left main disease) (Urban et al 2006). 2. The rising epidemic of obesity – associated with meta- bolic syndrome (hypertension, dyslipidemia, high fasting glucose) and early onset of atherosclerosis. 3. The advent of drug-eluting stents – resulting in improved outcomes and their resultant use in a broader range of indications (including diabetes/multi-vessel disease, in-stent restenosis, chronic total occlusions, bifurcations, saphenous vein grafts, and left main stem disease). Following the First-in-Manfeasibility study and the series of trials in which SES was compared with bare metal stents in relatively simple lesions, the body of clinical evidence was increased by additional data from trials on more complex lesions such as small vessels (Meier et al 2006; Ardis- sino et al 2004), chronic total occlusions (Jang et al 2006; Lotan et al 2006; Suttorp et al 2006), in-stent restenosis (Alfonso et al 2006; Holmes et al 2006), multi-vessel disease (Serruys et al 2005), acute myocardial infarction (Spaulding et al 2006), and patients with diabetes (Ortolani et al 2005; Sabate et al 2006). Additional data from the SIRIUS trial serve to conﬁrm the durability of outcomes with CYPHER stent and the impor- tance of inhibiting neointimal hyperplasia (NIH) and late loss as much as possible from the start. SIRIUS follow-up results presented at ACC showed that the highly signiﬁcant differences Vascular Health and Risk Management 2007:3(2) 193