Document Detail


Clinical outcomes of drug-eluting versus bare-metal in-stent restenosis.
MedLine Citation:
PMID:  19937786     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In-stent restenosis (ISR) is a challenging syndrome that affects drug-eluting stents and bare-metal stents. However, data comparing the outcomes of drug-eluting versus bare-metal ISR are limited. Our objective was to evaluate the long-term clinical outcomes of drug-eluting versus bare-metal ISR. Patients who underwent percutaneous coronary intervention at Cleveland Clinic for ISR from 05/1999 to 06/2007 were included. Unadjusted outcomes were tested using Kaplan-Meier curves followed by multivariable adjusted Cox proportional hazards analyses. Twenty seven variables, including type of stent used to treat ISR and procedural date, were included. The primary end point was a composite of death, myocardial infarction (MI), or target lesion revascularization (TLR). The secondary endpoints were components of the primary endpoint. Of 931 patients identified, 225 had drug-eluting ISR and 706 had bare-metal ISR. There were 279 cumulative events for a median follow-up of 3.2 years. The primary endpoint was not different between drug eluting and bare-metal ISR (22% versus 33%, adjusted hazard ratio [HR] 1.14; 95% confidence interval [CI], 0.79-1.66; P = 0.49). The secondary endpoints of death (8% versus 16%, adjusted HR 1.05; 95% CI, 0.56-1.98; P = 0.88), MI (4% versus 5%, adjusted HR 1.48; 95% CI, 0.54-4.04; P = 0.45), and TLR (15% versus 16%, adjusted HR 1.30; 95% CI, 0.81-2.11; P = 0.28) were also not different. This study represents the largest analysis comparing drug-eluting to bare-metal ISR. On multivariable Cox proportional hazard analyses, drug-eluting and bare-metal ISR have similar long term outcomes.
Authors:
Inder M Singh; Steven J Filby; Fredy El Sakr; Eiran Z Gorodeski; A Michael Lincoff; Stephen G Ellis; Mehdi H Shishehbor
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  75     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-26     Completed Date:  2010-06-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  338-42     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Cohort Studies
Coronary Restenosis / therapy*
Drug-Eluting Stents / adverse effects
Female
Humans
Male
Middle Aged
Proportional Hazards Models
Stents* / adverse effects
Treatment Outcome
Comments/Corrections
Comment In:
Catheter Cardiovasc Interv. 2010 Feb 15;75(3):343-4   [PMID:  20162699 ]

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


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