Long term Comparative Outcomes of Sirolimus versus Everolimus Eluting Coronary Stents A Single Centre Ambispective Study

Study Title: **DualDES:**Long-term Comparative Outcomes of Sirolimus- versus Everolimus-Eluting Coronary Stents A Single-Centre Ambispective Study

Study Design: A Real-World Evidence, Single-center, Observational, ambispective study.

Study Objective: This study aims to evaluate and compare the long-term safety, performance, and clinical outcomes of Sirolimus- versus Everolimus-eluting coronary stent systems in real-world patients with native coronary artery disease.

Rationale of the study: Drug-eluting stents (DES) have significantly improved the treatment of coronary artery disease (CAD) by reducing the incidence of restenosis, neointimal hyperplasia, and the need for repeat revascularization compared to bare-metal stents. Among the widely used DES, sirolimus- and everolimus-eluting stents utilize potent antiproliferative agents that inhibit smooth muscle cell proliferation and migration key contributors to restenosis. Both sirolimus and everolimus belong to the mTOR inhibitor class and are locally delivered at the site of the coronary lesion through polymer-coated stents. This targeted delivery maximizes efficacy at the lesion site while minimizing systemic drug exposure and related adverse effects. Although both agents share a similar mechanism of action, subtle differences in pharmacokinetics, stent design, polymer composition, and drug-release kinetics may influence their long-term clinical performance and safety profiles. This study aims to generate real-world, comparative evidence on the long-term safety, performance, and clinical outcomes associated with sirolimus- versus everolimus-eluting coronary stents in patients undergoing percutaneous coronary intervention