Document Detail


Effect of coronary target lesion revascularization on late cardiac events after insertion of sirolimus-eluting or bare metal stents.
MedLine Citation:
PMID:  20816116     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Restenosis is associated with acute myocardial infarction (MI) either at presentation or related to complications of target lesion revascularization (TLR). The cumulative late effect of TLR after drug-eluting or bare metal stent placement on cardiac death or MI is uncertain. Of the 1,057 patients with one native coronary lesion randomized to a sirolimus-eluting stent or bare metal stent in the Sirolimus-Eluting Stent in De Novo Native Coronary Lesions (SIRIUS) trial, the 983 who survived free of MI for the first 30 days were evaluated for the primary outcome of cardiac death or MI for 5 years. Patients with events occurring at or after TLR were assigned to TLR group. Cox proportional hazards regression analysis with TLR as a time-dependent variable and adjustment for baseline clinical and demographic covariates was used to assess the independent effect of TLR on the primary outcome. TLR occurred in 160 patients (16.3%) and was an independent predictor of the primary end point (hazard ratio 2.8, 95% confidence interval 1.7 to 4.5). This association was significant for sirolimus-eluting stents and bare metal stents. TLR was also associated with an increased risk of subsequent stent thrombosis and nontarget vessel revascularization. Intracoronary brachytherapy in the TLR group was associated with an increased risk of cardiac death or MI. In conclusion, restenosis requiring TLR was associated with an increased risk of cardiac death or MI occurring at TLR and during the subsequent 5 years.
Authors:
Victor Novack; Michael C Nguyen; Meredith Rooney; Riya Chacko; Lena Novack; Michael Pencina; Patricia Apruzzese; Laura Mauri; Sidney A Cohen; Jeffrey Moses; Martin B Leon; Donald E Cutlip
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-08-02
Journal Detail:
Title:  The American journal of cardiology     Volume:  106     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-06     Completed Date:  2010-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  774-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Harvard Clinical Research Institute, Boston, Massachusetts, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary*
Confidence Intervals
Coronary Restenosis / mortality,  prevention & control*
Drug-Eluting Stents*
Female
Follow-Up Studies
Humans
Immunosuppressive Agents / administration & dosage*
Male
Metals
Middle Aged
Myocardial Infarction / mortality,  therapy*
Odds Ratio
Proportional Hazards Models
Regression Analysis
Sirolimus / administration & dosage*
Stents
Treatment Outcome
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 0/Metals; 53123-88-9/Sirolimus

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


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