Document Detail


Long-term outcome in patients treated with sirolimus-eluting stents in complex coronary artery lesions: 3-year results of the SCANDSTENT (Stenting Coronary Arteries in Non-Stress/Benestent Disease) trial.
MedLine Citation:
PMID:  18498953     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Our purpose was to evaluate the long-term use of sirolimus-eluting stents (SES) and bare-metal stents (BMS) in patients with complex coronary artery lesions. BACKGROUND: Although the use of SES has proved to be effective in patients with simple coronary artery lesions, there are limited data of the long-term outcome of patients with complex coronary artery lesions. METHODS: We randomly assigned 322 patients with total coronary occlusions or lesions located in bifurcations, ostial, or angulated segments of the coronary arteries to have SES or BMS implanted. RESULTS: At 3 years, major adverse cardiac events had occurred in 20 patients (12%) in the SES group and in 59 patients (38%) in the BMS group (p < 0.001). Four versus 2 patients suffered a cardiac death (p = NS), and 5 versus 1 died of a noncardiac disease (p = NS) in the SES versus the BMS group. Six patients in the SES group versus 15 patients in the BMS group suffered a myocardial infarction (p < 0.05) during the 3-year observation period, and target lesion revascularization was performed in 8 patients (4.9%) versus 53 patients (33.8%), respectively (p < 0.001); of these, 4 in the SES versus 7 in the BMS group were performed between 1 and 3 years after the index treatment (p = NS). According to revised definitions, stent thrombosis occurred in 5 patients (3.1%) in the SES group and in 7 patients (4.4%) in the BMS group (p = NS); very late stent thrombosis was observed in 4 versus 1 patient. CONCLUSIONS: A continued benefit was observed up to 3 years after implantation of SES in patients with complex coronary artery lesions. The rate of late adverse events was similar in the 2 groups, and stent thromboses occurred rarely after 1 year. (Sirolimus Eluting Stents in Complex Coronary Lesions [SCANDSTENT]; NCT00151658)
Authors:
Henning Kelbaek; Lene Kløvgaard; Steffen Helqvist; Jens F Lassen; Lars R Krusell; Thomas Engstrøm; Hans E Bøtker; Erik Jørgensen; Kari Saunamäki; Samir Aljabbari; Per Thayssen; Anders Galløe; Gunnar V H Jensen; Leif Thuesen
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  51     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-23     Completed Date:  2008-06-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2011-6     Citation Subset:  AIM; IM    
Affiliation:
Rigshospitalet, Copenhagen, Denmark. henning.kelbaek@rh.regionh.dk
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00151658
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Disease / mortality,  pathology,  therapy*
Coronary Restenosis / epidemiology
Drug-Eluting Stents* / adverse effects
Female
Fibrinolytic Agents / therapeutic use
Follow-Up Studies
Humans
Kaplan-Meiers Estimate
Male
Middle Aged
Myocardial Infarction / epidemiology
Sirolimus / administration & dosage*
Stents* / adverse effects
Treatment Outcome
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; 53123-88-9/Sirolimus
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2008 May 27;51(21):2025-7   [PMID:  18498955 ]

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