Document Detail

Sirolimus- versus paclitaxel-eluting stents for the treatment of cardiac allograft vasculopathy.
MedLine Citation:
PMID:  20398863     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The aim of this study was to compare outcomes after percutaneous coronary intervention (PCI) with sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) in the treatment of cardiac allograft vasculopathy (CAV).
BACKGROUND: PCI in patients with CAV is associated with increased rates of restenosis compared with PCI in patients without CAV. There are no dedicated studies on the influence of different drug-eluting stents (DES) on the outcomes of patients with CAV.
METHODS: This is a retrospective observational study of 108 consecutive patients with CAV who underwent PCI with SES and PES at UCLA Medical Center and University of Padova Medical Center between 2002 and 2008.
RESULTS: Baseline characteristics were similar among SES (n = 68) and PES (n = 40) patients with the exception of older patients, larger minimal lumen diameter, and smaller diameter stenosis in the SES-treated patients. Angiographic follow-up at 1 year was high in the SES and PES groups (74% vs. 76%, p = 0.8). The SES and PES groups had similar binary restenosis rates (10% vs. 9%, p = 0.7), percent diameter stenosis (24 +/- 24% vs. 24 +/- 18%, p = 0.94), and late lumen loss (0.67 +/- 1.03 mm vs. 0.68 +/- 1.11 mm, p > 0.9). One-year clinical outcomes were not significantly different among CAV patients treated with either SES or PES (major adverse cardiac events: 10% vs. 15%, p = 0.5; death: 3% vs. 5%, p = 0.4; myocardial infarction: 3% vs. 5%, p = 0.4; target vessel revascularization: 4% vs. 8%, p = 0.3).
CONCLUSIONS: In patients who underwent PCI for CAV, both SES and PES were safe and effective with no significant differences in clinical and angiographic outcomes. Randomized clinical trials comparing different DES with longer follow-up are necessary to identify the optimal treatment strategy for patients with CAV.
Michael S Lee; Giuseppe Tarantini; Jola Xhaxho; Tae Yang; Ashkan Ehdaie; Ravi Bhatia; Enrico Favaretto; Jonathan Tobis
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  JACC. Cardiovascular interventions     Volume:  3     ISSN:  1876-7605     ISO Abbreviation:  JACC Cardiovasc Interv     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-19     Completed Date:  2010-07-09     Revised Date:  2014-09-05    
Medline Journal Info:
Nlm Unique ID:  101467004     Medline TA:  JACC Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  378-82     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Angioplasty, Balloon, Coronary / adverse effects,  instrumentation*
Cardiovascular Agents / administration & dosage*
Chi-Square Distribution
Coronary Angiography
Coronary Restenosis / etiology
Coronary Stenosis / drug therapy,  etiology,  mortality,  radiography,  therapy*
Drug-Eluting Stents*
Heart Transplantation / adverse effects*,  mortality
Los Angeles
Middle Aged
Myocardial Infarction
Paclitaxel / administration & dosage*
Prosthesis Design
Retrospective Studies
Severity of Illness Index
Sirolimus / administration & dosage*
Thrombosis / etiology
Time Factors
Transplantation, Homologous
Treatment Outcome
Reg. No./Substance:
0/Cardiovascular Agents; 33069-62-4/Paclitaxel; W36ZG6FT64/Sirolimus

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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