Document Detail


Clinical and angiographic follow-up of small vessel lesions treated with paclitaxel-eluting stents (from the TRUE Registry).
MedLine Citation:
PMID:  18929700     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Several randomized trials have shown that sirolimus-eluting stents and paclitaxel-eluting stents (PES) are effective in reducing restenosis in respect to bare-metal stents, including the subset of small vessels. The objective of this study was to evaluate "real world" angiographic and clinical outcomes of a large series of patients enrolled in the TRUE registry and treated with PES for both small vessel and very small vessel lesions. A consecutive series of 675 patients (926 lesions) with reference vessel diameter <2.75 mm measured by quantitative coronary angiography analysis were analyzed. The primary end point was the rate of angiographic in-stent restenosis and 1-year major adverse cardiac events. In this study 390 lesions were identified as small vessel (reference vessel diameter >or=2.25 and <2.75 mm) and 536 lesions as very small vessel (reference vessel diameter <2.25 mm). Overall in-stent restenosis was 15.5% (n = 96). Compared with small vessel, the very small vessel lesions had more in-stent restenosis (21.7% vs 11.4%, p <0.001) and in-segment restenosis (29.3% vs 22.5%, p = 0.055). The majority of the restenotic lesions (n = 125) were focal (57%, n = 71). At 1 year, cardiac death was 1.6% (n = 11), acute myocardial infarction 0.5% (n = 4.), and the target lesion revascularization 12.8% (n = 86). Cumulative major adverse cardiac events rate was 17.3% (n = 119). The rate of definite and probable stent thrombosis was 0.9% (n = 8). In conclusion, in comparison with historical bare-metal stent controls, this large series of small vessel lesions treated with PES confirms previous results reporting the efficacy of PES in small vessels. The rate of subacute and late stent thrombosis was low in this subgroup of patients.
Authors:
Cosmo Godino; Shinichi Furuichi; Azeem Latib; Nuccia Morici; Alaide Chieffo; Enrico Romagnoli; Corrado Tamburino; Rossella Barbagallo; Michela Cera; David Antoniucci; Omer Goktekin; Carlo Di Mario; Bernard Reimers; Eberhard Grube; Flavio Airoldi; Giuseppe M Sangiorgi; Antonio Colombo
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2008-07-26
Journal Detail:
Title:  The American journal of cardiology     Volume:  102     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-20     Completed Date:  2008-11-06     Revised Date:  2008-12-19    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1002-8     Citation Subset:  AIM; IM    
Affiliation:
Interventional Cardiology Unit, San Raffaele Institute, Milan, Italy. cosmogodino@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Vessel Prosthesis Implantation / methods*
Coated Materials, Biocompatible*
Coronary Angiography / methods*
Coronary Disease / radiography,  surgery*
Coronary Vessels / surgery*
Drug-Eluting Stents*
Female
Follow-Up Studies
Humans
Male
Paclitaxel / therapeutic use*
Prospective Studies
Registries
Severity of Illness Index
Time Factors
Treatment Outcome
Tubulin Modulators / therapeutic use
Chemical
Reg. No./Substance:
0/Coated Materials, Biocompatible; 0/Tubulin Modulators; 33069-62-4/Paclitaxel

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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