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Long-term clinical outcomes after sirolimus-eluting stent implantation for treatment of restenosis within bare-metal versus drug-eluting stents.
Catheter Cardiovasc Interv. 2008 Apr 01; 71(5):594-8.CC

Abstract

BACKGROUND

Sirolimus-eluting stents have been increasingly used for treatment of restenosis after implantation of bare metal stents (BMSs) or drug-eluting stents (DESs), but little is known regarding their long-term outcomes.

METHODS

We compared long-term clinical outcomes in 295 patients treated with sirolimus-eluting stents for post-BMS (n = 224) vs. post-DES (n = 71) restenosis. All follow-ups were at least 12 months, and the primary endpoint was major adverse cardiac events (MACE), defined as cardiac death, nonfatal myocardial infarction (MI) or target lesion revascularization (TLR).

RESULTS

Baseline characteristics were similar between the two groups, except that mean lesion length (28.0 +/- 16.2 vs. 19.5 +/- 13.6, P < 0.01) and mean stented length (35.4 +/- 19.2 vs. 25.7 +/- 14.7, P < 0.01) were significantly longer in the post-BMS group. Major in-hospital complications occurred in 2 patients. During a mean follow-up of 31.3 +/- 11.1 months, there were 9 deaths (4 cardiac, 5 noncardiac), 3 nonfatal MIs, and 25 TLRs. Late stent thrombosis was documented in 2 patients (1 in each group). There were no between group differences in cardiac or total deaths, but there were trends toward less frequent cardiac death/MI or TLR in the post-BMS group. The cumulative probability of MACE-free survival was significantly better for the post-BMS group (95.0% +/- 1.5% vs. 87.3% +/- 4.0% at 1 year; 93.0% +/- 1.7% vs. 81.0% +/- 5.2% at 2 years; Log Rank P = 0.016). In multivariate analysis, post-DES restenosis was the only significant predictor of MACE (OR 3.29, 95%CI 1.13-9.61, P = 0.029).

CONCLUSIONS

Sirolimus-eluting stents were effective for treatment of in-stent restenosis, but post-DES restenosis was associated with poorer outcomes than post-BMS restenosis.

Authors+Show Affiliations

Department of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18311841

Citation

Whan Lee, Cheol, et al. "Long-term Clinical Outcomes After Sirolimus-eluting Stent Implantation for Treatment of Restenosis Within Bare-metal Versus Drug-eluting Stents." Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, vol. 71, no. 5, 2008, pp. 594-8.
Whan Lee C, Kim SH, Suh J, et al. Long-term clinical outcomes after sirolimus-eluting stent implantation for treatment of restenosis within bare-metal versus drug-eluting stents. Catheter Cardiovasc Interv. 2008;71(5):594-8.
Whan Lee, C., Kim, S. H., Suh, J., Park, D. W., Lee, S. H., Kim, Y. H., Hong, M. K., Kim, J. J., Park, S. W., & Park, S. J. (2008). Long-term clinical outcomes after sirolimus-eluting stent implantation for treatment of restenosis within bare-metal versus drug-eluting stents. Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, 71(5), 594-8. https://doi.org/10.1002/ccd.21399
Whan Lee C, et al. Long-term Clinical Outcomes After Sirolimus-eluting Stent Implantation for Treatment of Restenosis Within Bare-metal Versus Drug-eluting Stents. Catheter Cardiovasc Interv. 2008 Apr 1;71(5):594-8. PubMed PMID: 18311841.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term clinical outcomes after sirolimus-eluting stent implantation for treatment of restenosis within bare-metal versus drug-eluting stents. AU - Whan Lee,Cheol, AU - Kim,Sang-Hyun, AU - Suh,Jon, AU - Park,Duk-Woo, AU - Lee,Seung-Hwan, AU - Kim,Young-Hak, AU - Hong,Myeong-Ki, AU - Kim,Jae-Joong, AU - Park,Seong-Wook, AU - Park,Seung-Jung, PY - 2008/3/4/pubmed PY - 2008/5/13/medline PY - 2008/3/4/entrez SP - 594 EP - 8 JF - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JO - Catheter Cardiovasc Interv VL - 71 IS - 5 N2 - BACKGROUND: Sirolimus-eluting stents have been increasingly used for treatment of restenosis after implantation of bare metal stents (BMSs) or drug-eluting stents (DESs), but little is known regarding their long-term outcomes. METHODS: We compared long-term clinical outcomes in 295 patients treated with sirolimus-eluting stents for post-BMS (n = 224) vs. post-DES (n = 71) restenosis. All follow-ups were at least 12 months, and the primary endpoint was major adverse cardiac events (MACE), defined as cardiac death, nonfatal myocardial infarction (MI) or target lesion revascularization (TLR). RESULTS: Baseline characteristics were similar between the two groups, except that mean lesion length (28.0 +/- 16.2 vs. 19.5 +/- 13.6, P < 0.01) and mean stented length (35.4 +/- 19.2 vs. 25.7 +/- 14.7, P < 0.01) were significantly longer in the post-BMS group. Major in-hospital complications occurred in 2 patients. During a mean follow-up of 31.3 +/- 11.1 months, there were 9 deaths (4 cardiac, 5 noncardiac), 3 nonfatal MIs, and 25 TLRs. Late stent thrombosis was documented in 2 patients (1 in each group). There were no between group differences in cardiac or total deaths, but there were trends toward less frequent cardiac death/MI or TLR in the post-BMS group. The cumulative probability of MACE-free survival was significantly better for the post-BMS group (95.0% +/- 1.5% vs. 87.3% +/- 4.0% at 1 year; 93.0% +/- 1.7% vs. 81.0% +/- 5.2% at 2 years; Log Rank P = 0.016). In multivariate analysis, post-DES restenosis was the only significant predictor of MACE (OR 3.29, 95%CI 1.13-9.61, P = 0.029). CONCLUSIONS: Sirolimus-eluting stents were effective for treatment of in-stent restenosis, but post-DES restenosis was associated with poorer outcomes than post-BMS restenosis. SN - 1522-726X UR - https://www.unboundmedicine.com/medline/citation/18311841/Long_term_clinical_outcomes_after_sirolimus_eluting_stent_implantation_for_treatment_of_restenosis_within_bare_metal_versus_drug_eluting_stents_ L2 - https://doi.org/10.1002/ccd.21399 DB - PRIME DP - Unbound Medicine ER -