Document Detail

Impact of target lesion and nontarget lesion cardiac events on 5-year clinical outcomes after sirolimus-eluting or bare-metal stenting.
MedLine Citation:
PMID:  19539252     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We sought to compare patient-oriented outcomes related to target vessel or nontarget vessel events for sirolimus-eluting stents (SES) versus bare-metal stents.
BACKGROUND: SES significantly reduce restenosis but the influence of reduced restenosis on overall patient-oriented outcome has not been reported.
METHODS: The study population included 1,057 patients randomized in the SIRIUS (Sirolimus-Eluting Stent in De Novo Native Coronary Lesions) study and followed clinically for 5 years. The primary end point was a composite of all-cause mortality, any myocardial infarction, or any repeat revascularization. In secondary analyses, myocardial infarction and repeat revascularization events attributed to the target vessel or a nontarget vessel were compared by stent type.
RESULTS: Patients with an SES were more likely to be free from the primary composite end point at 5 years (60.4% vs. 47.8%, p < 0.001) chiefly due to a sustained reduction in target lesion revascularization for SES (cumulative incidence: 12.5% vs. 28.8%, p < 0.001). There was no difference in the cumulative incidence of myocardial infarction or revascularization attributed to remote segments of the target vessel. Events attributed to the nontarget vessel were frequent and not different for SES versus bare-metal stents (25.7% vs. 25.8%).
CONCLUSIONS: The benefit of SES over bare-metal stents for reduced target lesion revascularization is maintained for 5 years. Remote coronary segments of the target vessel and nontarget vessel remain an important cause of future adverse events despite sustained restenosis benefit.
Riya Chacko; Meredith Mulhearn; Victor Novack; Lena Novack; Laura Mauri; Sidney A Cohen; Jeffrey Moses; Martin B Leon; Donald E Cutlip
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JACC. Cardiovascular interventions     Volume:  2     ISSN:  1876-7605     ISO Abbreviation:  JACC Cardiovasc Interv     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-22     Completed Date:  2009-08-27     Revised Date:  2014-09-05    
Medline Journal Info:
Nlm Unique ID:  101467004     Medline TA:  JACC Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  498-503     Citation Subset:  IM    
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MeSH Terms
Angioplasty, Balloon, Coronary / adverse effects,  instrumentation*,  mortality
Cardiovascular Agents / administration & dosage*
Coronary Artery Disease / mortality,  therapy*
Coronary Restenosis / etiology,  prevention & control
Disease Progression
Double-Blind Method
Drug-Eluting Stents*
Kaplan-Meier Estimate
Middle Aged
Myocardial Infarction / etiology,  prevention & control
Platelet Aggregation Inhibitors / therapeutic use
Proportional Hazards Models
Prosthesis Design
Risk Assessment
Risk Factors
Sirolimus / administration & dosage*
Time Factors
Treatment Outcome
Reg. No./Substance:
0/Cardiovascular Agents; 0/Metals; 0/Platelet Aggregation Inhibitors; W36ZG6FT64/Sirolimus
Comment In:
JACC Cardiovasc Interv. 2009 Jun;2(6):513-4   [PMID:  19539254 ]

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

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