Document Detail

Long-term clinical outcome of chronic total occlusive lesions treated with drug-eluting stents: comparison of sirolimus-eluting and paclitaxel-eluting stents.
MedLine Citation:
PMID:  20197629     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: There are few studies comparing the efficacy of different drug-eluting stents and their long-term clinical outcomes in percutaneous coronary intervention (PCI) of chronic total occlusive (CTO) lesions.
METHODS AND RESULTS: To compare the efficacy of sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) for CTO, and to identify predictors of outcome after PCI, 200 patients with at least 1 successfully revascularized CTO were enrolled into either a SES (n=132) or PES (n=71) group. At 6-9-month angiographic follow-up, SES was superior to PES (late loss 0.27+/-0.60 vs 0.53+/-0.62 mm, P=0.04). During mean follow-up of 2 years, the SES group had a significantly lower cumulative target vessel failure (TVF) rate than the PES group (14.9% vs 28.4%, P=0.01), as a consequence of lower target vessel revascularization (9.7% vs 23.9%, P=0.01) and also a partially lower rate of myocardial infarction (MI: 3.1% vs 7.6%, P=0.04). SES was also superior to PES in both early (<or=9 months) and late (>9 months) TVF (P=0.02 for log-rank test, respectively). Predictors for TVF were use of PES (hazard ratio (HR) 3.81, P<0.01), previous history of MI (HR 4.06, P<0.01), diabetes (HR 2.07, P=0.04) and chronic kidney disease (CKD; HR 3.56, P=0.05).
CONCLUSIONS: CTO lesions treated with SES showed better angiographic and long-term clinical outcomes than those treated with PES. Factors such as stent type, infarct-related CTO, diabetes and CKD affect the outcome of CTO intervention.
Seung-Pyo Lee; Song-Yi Kim; Kyung-Woo Park; Dong-Ho Shin; Hyun-Jae Kang; Bon-Kwon Koo; Jung-Won Suh; Young-Seok Cho; Tae-Jin Yeon; In-Ho Chae; Dong-Ju Choi; Hyo-Soo Kim
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-03-03
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  74     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-26     Completed Date:  2010-07-15     Revised Date:  2011-02-18    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  693-700     Citation Subset:  IM    
Cardiovascular Center, Seoul National University Hospital, Seoul, Korea.
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MeSH Terms
Angioplasty, Balloon, Coronary / methods*
Chronic Disease
Cohort Studies
Coronary Angiography
Coronary Occlusion / radiography,  therapy*
Drug-Eluting Stents*
Follow-Up Studies
Kaplan-Meier Estimate
Middle Aged
Myocardial Infarction / epidemiology
Treatment Failure
Treatment Outcome
Reg. No./Substance:
33069-62-4/Paclitaxel; 53123-88-9/Sirolimus

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