Document Detail


Comparison of effectiveness of bare metal stents versus drug-eluting stents in large (> or =3.5 mm) coronary arteries.
MedLine Citation:
PMID:  17317356     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Drug-eluting stents (DESs) are superior to bare metal stents (BMSs) in decreasing restenosis rates across a wide range of patient and lesion subsets. However, widespread utilization of DESs raises concerns with regard to risks of prolonged dual antiplatelet therapy, the potential for late adverse events such as late thrombosis, and cost. Vessel diameter and lesion length have been previously identified as predictors for restenosis for DESs and BMSs. This study compared the clinical outcomes of DESs versus BMSs in large coronary arteries (> or =3.5 mm). A cohort of 233 patients who underwent single-vessel angioplasty with DES implantation in large vessels was compared with 233 propensity-matched patients who received BMSs in vessels with similar reference vessel diameters. Clinical outcomes at 30 days, 6 months, and 1 year were compared between groups. Baseline clinical and procedural characteristics were similar. Target lesion revascularization and target vessel revascularization rates and the incidence of major adverse cardiac events were low and comparable between the 2 groups at all follow-up intervals. At 1 year, the primary outcome occurred in 8.5% of patients with DESs and 7.7% of patients with BMSs (p = 0.80). There were no episodes of subacute stent thrombosis or late thrombosis in either group. In conclusion, implantation of DESs in large coronary arteries confers no additional benefit compared with BMSs, and the 2 approaches are associated with equally favorable clinical outcomes at 1 year.
Authors:
Daniel H Steinberg; Sundeep Mishra; Aamir Javaid; Tina L Pinto Slottow; Ashesh N Buch; Probal Roy; Teruo Okabe; Kimberly A Smith; Rebecca Torguson; Zhenyi Xue; Augusto D Pichard; Lowell F Satler; Kenneth M Kent; William O Suddath; Ron Waksman
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2007-01-04
Journal Detail:
Title:  The American journal of cardiology     Volume:  99     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-02-23     Completed Date:  2007-04-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  599-602     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Washington Hospital Center, Washington, DC, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Cohort Studies
Coronary Disease / mortality,  therapy*
Equipment Design
Female
Humans
Immunosuppressive Agents / administration & dosage
Male
Middle Aged
Paclitaxel / administration & dosage
Retrospective Studies
Sirolimus / administration & dosage
Stents*
Survival Rate
Treatment Outcome
Tubulin Modulators / administration & dosage
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 0/Tubulin Modulators; 33069-62-4/Paclitaxel; 53123-88-9/Sirolimus

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


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