Document Detail


An everolimus-eluting stent versus a paclitaxel-eluting stent in small vessel coronary artery disease: a pooled analysis from the SPIRIT II and SPIRIT III trials.
MedLine Citation:
PMID:  20578194     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate the safety and efficacy of the XIENCE V everolimus-eluting stent compared to the TAXUS paclitaxel-eluting stent in small vessels. BACKGROUND: The XIENCE V everolimus-eluting stent (EES) has been shown to improve angiographic and clinical outcomes after percutaneous myocardial revascularization, but its performance in small coronary arteries has not been investigated. METHODS: In this pooled analysis, we studied a cohort of 541 patients with small coronary vessels (reference diameter <2.765 mm) by using patient and lesion level data from the SPIRIT II and SPIRIT III studies. TAXUS Express (73% of lesions) and TAXUS Liberté (27% of lesions) paclitaxel-eluting stents (PES) were used as controls in SPIRIT II. In SPIRIT III, Taxus Express(2) PES was the control. RESULTS: Mean angiographic in-stent and in-segment late loss was significantly less in the EES group compared with the PES group, (0.15 +/- 0.37 mm vs. 0.30 +/- 0.44 mm; P = 0.011 for in-stent; 0.10 +/- 0.38 mm vs. 0.21 +/- 0.34 mm; P = 0.034 for in-segment). EES also resulted in a significant reduction in composite major adverse cardiac events at 1 year (19/366 [5.2%] vs. 17/159 [10.7%]; P = 0.037), due to fewer non-Q-wave myocardial infarctions and target lesion revascularizations. At 1 year, the rate of non-Q-wave myocardial infarction was significantly lower in the EES group compared with that of the PES group (6/366 [1.6%] vs. 8/159 [5.0%]; P = 0.037). CONCLUSIONS: In patients with small vessel coronary arteries, the XIENCE V EES was superior to the TAXUS PES.
Authors:
Antonio L Bartorelli; Patrick W Serruys; Karine Miquel-Hébert; Shui Yu; Wes Pierson; Gregg W Stone;
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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:  76     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-01     Completed Date:  2010-10-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  60-6     Citation Subset:  IM    
Copyright Information:
(c) 2010 Wiley-Liss, Inc.
Affiliation:
Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico and Department of Cardiovascular Sciences, University of Milan, Monzino Via Parea 4, Milan, Italy. antonio.bartorelli@ccfm.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects,  instrumentation*,  mortality
Cardiovascular Agents / administration & dosage*
Coronary Angiography
Coronary Artery Disease / mortality,  radiography,  therapy*
Coronary Restenosis / etiology,  prevention & control
Drug-Eluting Stents*
Female
Humans
Kaplan-Meiers Estimate
Male
Middle Aged
Multicenter Studies as Topic
Myocardial Infarction / etiology,  prevention & control
Paclitaxel / administration & dosage*
Prosthesis Design
Randomized Controlled Trials as Topic
Retrospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Sirolimus / administration & dosage,  analogs & derivatives*
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Cardiovascular Agents; 159351-69-6/everolimus; 33069-62-4/Paclitaxel; 53123-88-9/Sirolimus
Comments/Corrections
Comment In:
Catheter Cardiovasc Interv. 2010 Jul 1;76(1):67-9   [PMID:  20578195 ]

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