| Safety of sirolimus-eluting stenting and its effect on restenosis in patients with unstable angina pectoris (a SIRIUS substudy). | |
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MedLine Citation:
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PMID: 17437725 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The SIRIUS study was a double-blinded, randomized trial of the sirolimus-eluting stent (SES) to evaluate its effect on the rate of restenosis. The present report is a retrospective analysis of short- and long-term outcomes of SESs compared with bare metal stents (BMSs) in a subgroup of patients with unstable angina enrolled in the trial. Of 1,058 patients randomized in SIRIUS, 533 (50.4%) had unstable angina pectoris and 490 had stable angina. In the unstable angina group, patients treated with SESs and BMSs had similar clinical and angiographic characteristics. The stenting procedure was highly successful in the 2 groups (95.9% and 97.4%, respectively) with similar immediate angiographic results and short-term (in-hospital) clinical event rates. At 1-year follow-up, compared with BMSs, patients with unstable angina treated with SESs had significantly lower rates of target lesion revascularization (5.5% vs 22.3%, p <0.0001), target vessel failure (10.9% vs 26.3%, p <0.0001), and major adverse cardiac events (8.4% vs 24.8%, p <0.0001). Stent thrombosis was a rare event, with only 1 patient (0.4%) in each group during the first 30 days. Late thrombosis occurred in 2 patients (0.7%) in the BMS group but in none of the SES group. In conclusion, in the higher risk subgroup of patients with unstable angina, SESs are as safe as BMSs in decreasing restenosis and the need for repeat revascularization. This is reflected by a significant decrease in major adverse cardiac events and target vessel failure. Patients with unstable angina undergoing percutaneous coronary intervention who meet the entry criteria of the SIRIUS study should be preferentially treated with SESs. |
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Authors:
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Giora Weisz; Jeffrey W Moses; Paul S Teirstein; David R Holmes; Albert E Raizner; Lowell F Satler; Gregory Mishkel; Robert L Wilensky; Patrick Wang; Richard E Kuntz; Jeffrey J Popma; Martin B Leon |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial Date: 2007-02-26 |
Journal Detail:
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Title: The American journal of cardiology Volume: 99 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2007 Apr |
Date Detail:
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Created Date: 2007-04-17 Completed Date: 2007-06-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1044-50 Citation Subset: AIM; IM |
Affiliation:
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Columbia University Medical Center, and Cardiovascular Research Foundation, New York, New York., USA. gweisz@crf.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angina, Unstable
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therapy* Angioplasty, Transluminal, Percutaneous Coronary Aspirin / therapeutic use Coronary Angiography Coronary Restenosis / etiology* Double-Blind Method Female Fibrinolytic Agents / administration & dosage* Follow-Up Studies Humans Male Middle Aged Platelet Aggregation Inhibitors / therapeutic use Retreatment Retrospective Studies Safety Sirolimus / administration & dosage* Stents* Survival Rate Ticlopidine / analogs & derivatives, therapeutic use Time Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents; 0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin; 53123-88-9/Sirolimus; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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