|Evaluation of the effects of everolimus-eluting and paclitaxel-eluting stents on target lesions with jailed side branches: 2-year results from the SPIRIT III randomized trial.|
|PMID: 20506356 Owner: NLM Status: MEDLINE|
|OBJECTIVE: To evaluate whether an everolimus-eluting stent (EES) with thinner stent struts and polymer results in less periprocedural myonecrosis and adverse outcomes.
BACKGROUND: Higher periprocedural myocardial infarction (MI) rates have been reported with the TAXUS® EXPRESS(2) paclitaxel-eluting stent (PES) compared to the bare metal EXPRESS(2)® stent due to more frequent side branch compromise, presumably attributable to the thickness of the stent/polymer on the PES.
METHODS: In the SPIRIT III trial, we identified 113 patients in the XIENCE V® EES group and 63 patients in the TAXUS EXPRESS(2) PES group who met the criteria of having a lesion with a jailed side branch (<2 mm diameter, and <50% stenosis). Two-year clinical outcomes were evaluated.
RESULTS: A periprocedural increase in Creatine Kinase-MB >1× upper normal level occurred in 9.0% of EES compared to 29.7% of PES patients with jailed side branches, P = 0.01. Through 2 years, major adverse cardiac events (MACE; cardiac death, MI, or target lesion revascularization [TLR]) occurred in 6.8% of EES and 19.0% of PES jailed side branch patients (P = 0.03), with numerically lower rates of MI (2.9% vs. 10.3%, P = 0.07) and TLR (3.9% vs. 10.3%, P = 0.17) in the EES group, with comparable rates of cardiac death (1.9% vs. 1.7%, P = 1.00).
CONCLUSIONS: In this post-hoc analysis of the SPIRIT III RCT, patients undergoing stenting of target lesions with jailed side branches with the thin strut and polymer XIENCE V EES compared to the thicker strut TAXUS PES had lower rates of MACE through 2 years due to fewer MIs and TLRs. © 2010 Wiley-Liss, Inc.
|Robert Applegate; James Hermiller; Jerome Williams; Paul Gordon; Julie Doostzadeh; Sherry Cao; Xiaolu Su; Krishnankutty Sudhir; Alexandra Lansky; Charles Simonton; Gregg Stone|
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|Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial|
|Title: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions Volume: 76 ISSN: 1522-726X ISO Abbreviation: Catheter Cardiovasc Interv Publication Date: 2010 Nov|
|Created Date: 2010-10-26 Completed Date: 2011-02-09 Revised Date: 2014-07-30|
Medline Journal Info:
|Nlm Unique ID: 100884139 Medline TA: Catheter Cardiovasc Interv Country: United States|
|Languages: eng Pagination: 644-51 Citation Subset: IM|
|APA/MLA Format Download EndNote Download BibTex|
Angioplasty, Balloon, Coronary / adverse effects, instrumentation*, mortality
Biological Markers / blood
Cardiovascular Agents / administration & dosage*
Coronary Artery Disease / mortality, radiography, therapy*
Creatine Kinase, MB Form / blood
Myocardial Infarction / blood, etiology, pathology, prevention & control*
Myocardium / enzymology, pathology
Paclitaxel / administration & dosage*
Severity of Illness Index
Sirolimus / administration & dosage, analogs & derivatives*
|0/Biological Markers; 0/Cardiovascular Agents; 159351-69-6/everolimus; 33069-62-4/Paclitaxel; EC 18.104.22.168/Creatine Kinase, MB Form; W36ZG6FT64/Sirolimus|
Catheter Cardiovasc Interv. 2010 Dec 1;76(7):1076-7; author reply 1078
Catheter Cardiovasc Interv. 2010 Nov 1;76(5):652-3 [PMID: 20976746 ]
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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