Document Detail

Late progression after sirolimus-eluting stent implantation for de novo lesions--comparison with bare metal stent implantation.
MedLine Citation:
PMID:  20378997     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In previous studies, the minimal luminal diameter (MLD) of lesions treated with a bare metal stent (BMS) was shown to improve from 6 months to 3 years. However, the long-term response to a sirolimus-eluting stent (SES) implantation remains unclear.
METHODS AND RESULTS: To evaluate 6-month, 12-month and 3-year outcomes, clinical and angiographic follow-up data were analyzed for 367 consecutive patients (506 de novo lesions) who underwent successful SES implantation compared to follow-up data for 617 consecutive patients (802 de novo lesions) who underwent BMS implantation. Clinical follow-up information was obtained for 363 SES-treated patients (98.9%) and 581 BMS-treated patients (94.2%) at 1 year, and 334 SES-treated patients (91.0%) and 566 BMS-treated patients (91.7%) at 3 years. At 3 years, there were no significant differences in the cumulative cardiac death and myocardial infarction. Target lesion revascularization (TLR) rates were significantly higher in BMS-treated patients than in SES-treated patients. In BMS-treated patients, most TLR was performed within 450 days, however, after 450 days, the TLR rate was significantly lower than that for the SES-treated patients. In quantitative coronary angiographic data, among lesions that required no revascularization at the initial 12-month follow up, MLD increased significantly from the 12-month to the 3-year follow-up angiography in BMS-treated lesions. However, MLD decreased significantly in SES-treated lesions.
CONCLUSIONS: From a 12-month follow-up to a 3-year follow-up, stenosis in BMS-treated lesions regressed, but stenosis in SES-treated lesions progressed. And late TLR was more frequently required in the SES-treated patients.
Nobuo Shiode; Kinya Shirota; Fumiyo Tsunoda; Yasuko Kato; Mai Fujiwara; Asao Mimura
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article     Date:  2010-04-06
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  74     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-27     Completed Date:  2010-09-07     Revised Date:  2011-02-18    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1104-10     Citation Subset:  IM    
Department of Cardiology, Matsue Red Cross Hospital, Matsue, Japan.
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MeSH Terms
Aged, 80 and over
Constriction, Pathologic / etiology
Disease Progression
Drug-Eluting Stents / adverse effects*
Middle Aged
Myocardial Infarction
Retrospective Studies
Sirolimus / administration & dosage*,  adverse effects
Stents / adverse effects
Treatment Outcome
Reg. No./Substance:

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