Document Detail


Safety of sirolimus-eluting stenting and its effect on restenosis in patients with unstable angina pectoris (a SIRIUS substudy).
MedLine Citation:
PMID:  17437725     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2007-02-26
Journal Detail:
Title:  The American journal of cardiology     Volume:  99     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-17     Completed Date:  2007-06-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1044-50     Citation Subset:  AIM; IM    
Affiliation:
Columbia University Medical Center, and Cardiovascular Research Foundation, New York, New York., USA. gweisz@crf.org
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MeSH Terms
Descriptor/Qualifier:
Angina, Unstable / 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:
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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