Document Detail


Drug-eluting stents for the treatment of ostial coronary lesions: comparison of sirolimus-eluting stent with paclitaxel-eluting stent.
MedLine Citation:
PMID:  18923247     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Treatment of ostial coronary lesions represents a challenge for interventional cardiologists. The efficacy of drug-eluting stents (DES) has been demonstrated as improving the outcomes of patients in a few studies. It is not known, however, which DES, sirolimus-eluting stent (SES) versus paclitaxel-eluting stent (PES), is superior for the treatment of ostial lesions. METHODS: In this retrospective study, 95 consecutive patients with de-novo ostial lesions underwent coronary SES (n=47, lesions=48) or PES implantation (n=45, lesions=47), and quantitative coronary analysis was performed at the time of stent implantation and subsequently at 8 months post stenting. Ostial lesion was defined as > or =50% diameter stenosis rising within 3 mm of either left anterior descending coronary artery or left circumflex artery or right coronary artery measured by quantitative coronary analysis. Major adverse cardiac events including death, thrombosis, nonfatal myocardial infarction, and target lesion revascularization were compared between the two groups. RESULTS: Baseline clinical and angiographic characteristics were well balanced between the two groups. At 8 months clinical and angiographic follow-up, overall major adverse cardiac events and target lesion revascularization rates were similar in both groups (6.4 vs. 11.2%, P=0.184; 4.3 vs. 8.9%, P=0.170, respectively). The in-stent and in-segment restenosis were, however, significantly higher in PES group compared with SES group (15.5 vs. 0%, P=0.001; 22.2 vs. 4.3%, P=0.003). Similarly, the late loss in both in-stent and in-segment was significantly higher in the PES group than in SES group (0.65+ or -0.67 vs. 0.16+ or -0.18 mm; 0.68+ or -0.65 vs. 0.15+ or -0.12 mm; P<0.001, respectively). CONCLUSION: In this small sample-size, nonrandomized, and nonprospective study, the data indicated that implantation of DES appears safe and effective for the treatment of patients with de-novo ostial coronary lesions, but SES implantation showed more favorable results in respect of restenosis compared with PES implantation.
Authors:
Jue Chen; Jian-Jun Li; Ji-Lin Chen; Shu-Bing Qiao; Bo Xu; Yue-Jin Yang; Run-Lin Gao; Xue-Wen Qin; Jin-Qing Yuan; Min Yao; Yong-Jian Wu; Hai-Bo Liu; Jun Dai; Shi-Jie You
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Coronary artery disease     Volume:  19     ISSN:  0954-6928     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-16     Completed Date:  2009-01-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  507-11     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, PR China.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects,  instrumentation*
Cardiovascular Agents / administration & dosage*
Cardiovascular Diseases / etiology,  prevention & control
Coronary Angiography
Coronary Restenosis / etiology,  prevention & control
Coronary Stenosis / radiography,  therapy*
Drug-Eluting Stents*
Female
Humans
Male
Middle Aged
Odds Ratio
Paclitaxel / administration & dosage*
Retrospective Studies
Risk Assessment
Sirolimus / administration & dosage*
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Cardiovascular Agents; 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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