Document Detail


Sirolimus-eluting and paclitaxel-eluting stents for coronary revascularization.
MedLine Citation:
PMID:  16105989     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2005-08-16
Journal Detail:
Title:  The New England journal of medicine     Volume:  353     ISSN:  1533-4406     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-18     Completed Date:  2005-08-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  653-62     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2005 Massachusetts Medical Society.
Affiliation:
Department of Cardiology, University Hospital Bern, Bern, Switzerland. stephan.windecker@insel.ch
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MeSH Terms
Descriptor/Qualifier:
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:
0/Immunosuppressive Agents; 33069-62-4/Paclitaxel; 53123-88-9/Sirolimus
Comments/Corrections
Comment In:
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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