Document Detail


Sirolimus versus paclitaxel coronary stents in clinical practice.
MedLine Citation:
PMID:  20506333     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVES: We aimed at comparing the long term clinical outcome of SES and PES in routine clinical practice.
BACKGROUND: Although sirolimus-eluting stents (SES) more effectively reduce neointimal hyperplasia than paclitaxel-eluting stents (PES), uncertainty prevails whether this difference translates into differences in clinical outcomes outside randomized controlled trials with selected patient populations and protocol-mandated angiographic follow-up.
METHODS: Nine hundred and four consecutive patients who underwent implantation of a drug-eluting stent between May 2004 and February 2005: 467 patients with 646 lesions received SES, 437 patients with 600 lesions received PES. Clinical follow-up was obtained at 2 years without intervening routine angiographic follow-up. The primary endpoint was a composite of death, myocardial infarction (MI), or target vessel revascularization (TVR).
RESULTS: At 2 years, the primary endpoint was less frequent with SES (12.9%) than PES (17.6%, HR = 0.70, 95% CI 0.50-0.98, P = 0.04). The difference in favor of SES was largely driven by a lower rate of target lesion revascularisation (TLR; 4.1% vs. 6.9%, P = 0.05), whereas rates of death (6.4% vs. 7.6%, P = 0.49), MI (1.9% vs. 3.2%, P = 0.21), or definite stent thrombosis (0.6% vs. 1.4%, P = 0.27) were similar for both stent types. The benefit regarding reduced rates of TLR was significant in nondiabetic (3.6% vs. 7.1%, P = 0.04) but not in diabetic patients (5.6% vs. 6.1%, P = 0.80).
CONCLUSIONS: SES more effectively reduced the need for repeat revascularization procedures than PES when used in routine clinical practice. The beneficial effect is maintained up to 2 years and may be less pronounced in diabetic patients.
Authors:
Niklas Millauer; Peter Jüni; Alexandra Hofmann; Simon Wandel; Anupham Bhambhani; Michael Billinger; Niklaus Urwyler; Peter Wenaweser; Gerrit Hellige; Lorenz Räber; Stéphane Cook; Rolf Vogel; Mario Togni; Christian Seiler; Bernhard Meier; Stephan Windecker
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  77     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  5-12     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Wiley-Liss, Inc.
Affiliation:
Department of Cardiology, Bern University Hospital, Bern, Switzerland.
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Comment In:
Catheter Cardiovasc Interv. 2011 Jan 1;77(1):13-4   [PMID:  21181967 ]

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