| Sirolimus-eluting and paclitaxel-eluting stents for coronary revascularization. | |
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MedLine Citation:
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PMID: 16105989 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Sirolimus-eluting stents and paclitaxel-eluting stents, as compared with bare-metal stents, reduce the risk of restenosis. It is unclear whether there are differences in safety and efficacy between the two types of drug-eluting stents. METHODS: We conducted a randomized, controlled, single-blind trial comparing sirolimus-eluting stents with paclitaxel-eluting stents in 1012 patients undergoing percutaneous coronary intervention. The primary end point was a composite of major adverse cardiac events (death from cardiac causes, myocardial infarction, and ischemia-driven revascularization of the target lesion) by nine months. Follow-up angiography was completed in 540 of 1012 patients (53.4 percent). RESULTS: The two groups had similar baseline clinical and angiographic characteristics. The rate of major adverse cardiac events at nine months was 6.2 percent in the sirolimus-stent group and 10.8 percent in the paclitaxel-stent group (hazard ratio, 0.56; 95 percent confidence interval, 0.36 to 0.86; P=0.009). The difference was driven by a lower rate of target-lesion revascularization in the sirolimus-stent group than in the paclitaxel-stent group (4.8 percent vs. 8.3 percent; hazard ratio, 0.56; 95 percent confidence interval, 0.34 to 0.93; P=0.03). Rates of death from cardiac causes were 0.6 percent in the sirolimus-stent group and 1.6 percent in the paclitaxel-stent group (P=0.15); the rates of myocardial infarction were 2.8 percent and 3.5 percent, respectively (P=0.49); and the rates of angiographic restenosis were 6.6 percent and 11.7 percent, respectively (P=0.02). CONCLUSIONS: As compared with paclitaxel-eluting stents, the use of sirolimus-eluting stents results in fewer major adverse cardiac events, primarily by decreasing the rates of clinical and angiographic restenosis. |
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Authors:
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Stephan Windecker; Andrea Remondino; Franz R Eberli; Peter Jüni; Lorenz Räber; Peter Wenaweser; Mario Togni; Michael Billinger; David Tüller; Christian Seiler; Marco Roffi; Roberto Corti; Gabor Sütsch; Willibald Maier; Thomas Lüscher; Otto M Hess; Matthias Egger; Bernhard Meier |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2005-08-16 |
Journal Detail:
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Title: The New England journal of medicine Volume: 353 ISSN: 1533-4406 ISO Abbreviation: N. Engl. J. Med. Publication Date: 2005 Aug |
Date Detail:
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Created Date: 2005-08-18 Completed Date: 2005-08-23 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0255562 Medline TA: N Engl J Med Country: United States |
Other Details:
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Languages: eng Pagination: 653-62 Citation Subset: AIM; IM |
Copyright Information:
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Copyright 2005 Massachusetts Medical Society. |
Affiliation:
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Department of Cardiology, University Hospital Bern, Bern, Switzerland. stephan.windecker@insel.ch |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Transluminal, Percutaneous Coronary Coronary Angiography Coronary Disease / mortality, therapy* Coronary Restenosis / epidemiology, prevention & control*, therapy Female Follow-Up Studies Humans Immunosuppressive Agents / administration & dosage* Male Middle Aged Myocardial Infarction / epidemiology Paclitaxel / administration & dosage* Proportional Hazards Models Single-Blind Method Sirolimus / administration & dosage* Stents* Survival Analysis |
| Chemical | |
Reg. No./Substance:
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0/Immunosuppressive Agents; 33069-62-4/Paclitaxel; 53123-88-9/Sirolimus |
| Comments/Corrections | |
Comment In:
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N Engl J Med. 2005 Aug 18;353(7):724-7
[PMID:
16105991
]
N Engl J Med. 2005 Dec 1;353(22):2404-8; author reply 2404-8 [PMID: 16320455 ] N Engl J Med. 2005 Dec 1;353(22):2404-8; author reply 2404-8 [PMID: 16320452 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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