OBJECTIVES: The purpose of this study was to investigate the impact of 
everolimus-eluting stents (EES) in comparison with bare-metal stents (BMS), 
sirolimus-eluting stents (SES), and paclitaxel-eluting stents (PES) on the 
6-month clinical outcomes in an all-comer population.
BACKGROUND: EES have been shown to be effective in the context of randomized 
trials with selected patients. The effect of EES implantation in more complex, 
unselected patients cannot be directly extrapolated from these findings.
METHODS: In total, 649 consecutive unselected patients treated exclusively with 
EES were enrolled. Six-month clinical end points were compared with 3 historical 
cohorts (BMS, n = 450; SES, n = 508; and PES, n = 576). Major adverse cardiac 
events (MACE) were defined as a composite of all-cause mortality, myocardial 
infarction, or target vessel revascularization (TVR).
RESULTS: The patients treated with EES were older, presented more frequently 
with acute myocardial infarction, and had more complicated lesions than the 
other groups. The EES group demonstrated a higher incidence of all-cause 
mortality than the SES group and a lower incidence of TVR than the BMS group. 
Multivariate adjustment demonstrated that BMS was associated with higher TVR and 
MACE risk than EES (adjusted hazard ratio [HR] for TVR: 2.02 [95% confidence 
interval (CI): 1.11 to 3.67]; adjusted HR for MACE: 2.15 [95% CI: 1.36 to 
3.42]); that SES had a clinical outcome similar to that of EES, and that PES had 
a higher risk of MACE than did EES (adjusted HR: 1.57 [95% CI: 1.02 to 2.44]).
CONCLUSIONS: This study suggests that the use of EES in an unselected population 
may be as safe as and more effective than BMS, may be as safe and effective as 
SES, may be as safe as PES, and may be more effective than PES.