Abstract: AIM: To compare the clinical efficacy of titanium nitric oxide biologically active stents (Titan2-BAS) and sirolimus-eluting stents (SES) in coronary revascularization. METHODS: One hundred and forty one patients with coronary artery disease were enrolled. Eighty seven patients were enrolled in group A treated with titanium nitric oxide biological active stents, whereas the other 54 patients were enrolled in group B treated with sirolimus-eluting stents. The reference vessel diameter was (3.1±0.4) mm and lesion length was (24±3) mm in group A, whereas diameters and length were (3.0±0.5) mm and (22±4) mm long, respectively, in group B with no significant difference between groups. All stents were implanted through either radial or ulnar artery approach. Patients in group A were given aspirin and clopidogrel for 1 to 3 months, whereas patients in group B used these for at least 12 months. The stent delivery success rate, incidence of early in-stent thrombosis and MACE (death, acute myocardial infarction, and target vessel revascularization) were analyzed in both groups during follow-up. RESULTS: In group A, 168 Titan2-BAS were implanted in 147 lesions with stenosis >75%. One stent failed to cross the lesion, the delivery success rate being 99.3%. In group B, 94 units of SES were implanted in 86 lesions, the delivery success rate being 100%. No significant difference was observed between groups. Follow-up period ranged from 1 to 17 months, with an average of 5.8 months. No deaths were found in both groups. There was no acute or late in-stent thrombosis in group A but one patient in group B suffered from in-stent thrombosis 2 days after the procedure. One patient underwent revascularization 3 months after the procedure in group A and no revascularizations were done in group B. No significant difference on MACE was found between groups. CONCLUSION: Our results suggest that Titan2-BAS is as good as SES in short- and long-term efficacy in coronary revascularization. Application of Titan2-BAS will not increase MACE.