Document Detail


A randomized comparison of sirolimus- versus Paclitaxel-eluting stent implantation in patients with diabetes mellitus.
MedLine Citation:
PMID:  18718419     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to compare the effectiveness of sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) in patients with diabetes mellitus (DM). BACKGROUND: Drug-eluting stent implantation significantly improved the angiographic and clinical outcomes compared with bare-metal stent implantation in diabetic patients. However, comparison of SES with PES in diabetic patients has not been sufficiently evaluated. METHODS: This prospective, multicenter, randomized study compared SES (n = 200) and PES implantation (n = 200) for diabetic patients (n = 400). The primary end point was in-segment restenosis at 6 months according to intention-to-treat principle. RESULTS: The 2 groups had similar baseline clinical and angiographic characteristics. Six-month in-stent (3.4% vs. 18.2%, p < 0.001) and in-segment restenosis (4.0% vs. 20.8%, p < 0.001) and 9-month target lesion revascularization (2.0% vs. 7.5%, p = 0.017) were significantly lower in the SES versus the PES group. The incidence of death (0% in SES vs. 0.5% in PES, p = 0.999) or myocardial infarction (0.5% in SES vs. 0.5% in PES, p = 0.999) at 9-month follow-up was not statistically different between the 2 groups. Major adverse cardiac events including death, myocardial infarction, and target lesion revascularization at 9 months (2.0% vs. 8.0%, p = 0.010) were lower in the SES versus the PES group. CONCLUSIONS: Sirolimus-eluting stent implantation is superior in reducing angiographic restenosis and improving 9-month clinical outcomes in patients with DM and coronary artery disease compared with PES implantation.
Authors:
Seung-Whan Lee; Seong-Wook Park; Young-Hak Kim; Sung-Cheol Yun; Duk-Woo Park; Cheol Whan Lee; Myeong-Ki Hong; Kyoung-Suk Rhee; Jei Keon Chae; Jae-Ki Ko; Jae-Hyeong Park; Jae-Hwan Lee; Si Wan Choi; Jin-Ok Jeong; In-Whan Seong; Yoon Haeng Cho; Nae-Hee Lee; June Hong Kim; Kook-Jin Chun; Hyun-Sook Kim; Seung-Jung Park
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  52     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-22     Completed Date:  2008-10-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  727-33     Citation Subset:  AIM; IM    
Affiliation:
Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Vessel Prosthesis Implantation
Cohort Studies
Coronary Stenosis / etiology,  radiography,  therapy*
Diabetes Complications / complications,  radiography,  therapy*
Drug-Eluting Stents*
Female
Graft Occlusion, Vascular / prevention & control
Humans
Immunosuppressive Agents / administration & dosage*
Male
Middle Aged
Paclitaxel / administration & dosage*
Sirolimus / administration & dosage*
Treatment Outcome
Tubulin Modulators / administration & dosage*
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 0/Tubulin Modulators; 33069-62-4/Paclitaxel; 53123-88-9/Sirolimus

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


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