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Firebird and cypher sirolimus-eluting stents and bare metal stents in treatment of very long coronary lesions.
Chin Med J (Engl). 2008 Aug 20; 121(16):1518-23.CM

Abstract

BACKGROUND

As a kind of sirolimus-eluting stent (SES) made in China, Firebird SES is more effective than bare metal stent (BMS) and not inferior to Cypher SES for short coronary lesions in terms of reduction of restenosis and revascularization. However, Firebird SES does not show any benefits in patients with a very long coronary lesion (VLCL). The present study was undertaken to evaluate the safety and efficacy of Firebird SES for VLCL by comparison of Cypher SES and BMS.

METHODS

In this prospective, nonrandomized and comparative study, eligible patients with de novo coronary lesion (> or = 30 mm) between January 2005 and June 2006 were allocated into Firebird SES group, Cypher SES group or BMS group. They were subjected to an angiographic follow-up of 6 months and a clinical follow-up of 12 months. The primary endpoints constitute the in-stent and in-segment restenosis rates at 6 months. The secondary endpoint was defined as a major adverse cardiovascular event (MACE) that was a 12-month combined endpoint of all-cause deaths, reinfarction or in-stent thrombosis, and target-lesion revascularization. The 12-month in-stent thrombosis was also evaluated to address the safety of Firebird SES implantation exceptionally.

RESULTS

A total of 468 patients were assessed for eligibility. Of 113 patients who were finally included according to the prior inclusion and exclusion criteria, 39 (41 lesions) were treated with Firebird SES, 37 (39 lesions) with Cypher SES, and 37 (37 lesions) with BMS. There were no significant differences in the baseline characteristics between the three groups; but there were longer lesions, more frequent use of overlapping stent in the Firebird SES group and the Cypher SES group. Angiographic follow-up showed that the rates of binary stenosis were similar between the Firebird SES group and the Cypher SES group (in-segment: 14.6% vs 12.8%, relative risk (RR) 1.14, P = 0.81; in-stent: 9.8% vs 10.3%, RR 0.95, P = 0.94), and significantly lower than those in the BMS group (in-segment: vs. 36.1%, RR 0.41 or 0.36, P = 0.04 or 0.03, respectively; in-stent: vs 30.6%, RR 0.32 or 0.34, P = 0.03 or 0.04, respectively). The total MACE rate up to 12 months was also similar in both SES groups (7.7% vs 5.4%, P = 1.000), and significantly lower than that in the BMS group (27.0%, P = 0.034 or 0.024, respectively). The in-stent thrombosis rate in the follow-up period was 2.6% in the Firebird SES group, not higher in the Cypher SES and BMS groups (2.7% and 2.7%, respectively, P = 1.000).

CONCLUSIONS

In the treatment of VLCL, Firebird SES would be safer and more effective than BMS. Firebird SES may be not inferior to Cypher SES in terms of restenosis and MACE.

Authors+Show Affiliations

Department of Cardiology, Union Hospital, Fujian Medical University & Fujian Provincial Institute of Coronary Disease, Fuzhou, Fujian 350001, China.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
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18982862

Citation

Fan, Lin, et al. "Firebird and Cypher Sirolimus-eluting Stents and Bare Metal Stents in Treatment of Very Long Coronary Lesions." Chinese Medical Journal, vol. 121, no. 16, 2008, pp. 1518-23.
Fan L, Chen LL, Lin CG, et al. Firebird and cypher sirolimus-eluting stents and bare metal stents in treatment of very long coronary lesions. Chin Med J. 2008;121(16):1518-23.
Fan, L., Chen, L. L., Lin, C. G., Peng, Y. F., Zheng, X. C., Luo, Y. K., Zhang, F. L., Chen, J. H., Yan, X. P., & Huang, Z. R. (2008). Firebird and cypher sirolimus-eluting stents and bare metal stents in treatment of very long coronary lesions. Chinese Medical Journal, 121(16), 1518-23.
Fan L, et al. Firebird and Cypher Sirolimus-eluting Stents and Bare Metal Stents in Treatment of Very Long Coronary Lesions. Chin Med J. 2008 Aug 20;121(16):1518-23. PubMed PMID: 18982862.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Firebird and cypher sirolimus-eluting stents and bare metal stents in treatment of very long coronary lesions. AU - Fan,Lin, AU - Chen,Liang-long, AU - Lin,Chao-gui, AU - Peng,Ya-fei, AU - Zheng,Xing-chun, AU - Luo,Yu-kun, AU - Zhang,Fei-long, AU - Chen,Jian-hua, AU - Yan,Xiao-ping, AU - Huang,Zheng-rong, PY - 2008/11/6/pubmed PY - 2008/12/17/medline PY - 2008/11/6/entrez SP - 1518 EP - 23 JF - Chinese medical journal JO - Chin. Med. J. VL - 121 IS - 16 N2 - BACKGROUND: As a kind of sirolimus-eluting stent (SES) made in China, Firebird SES is more effective than bare metal stent (BMS) and not inferior to Cypher SES for short coronary lesions in terms of reduction of restenosis and revascularization. However, Firebird SES does not show any benefits in patients with a very long coronary lesion (VLCL). The present study was undertaken to evaluate the safety and efficacy of Firebird SES for VLCL by comparison of Cypher SES and BMS. METHODS: In this prospective, nonrandomized and comparative study, eligible patients with de novo coronary lesion (> or = 30 mm) between January 2005 and June 2006 were allocated into Firebird SES group, Cypher SES group or BMS group. They were subjected to an angiographic follow-up of 6 months and a clinical follow-up of 12 months. The primary endpoints constitute the in-stent and in-segment restenosis rates at 6 months. The secondary endpoint was defined as a major adverse cardiovascular event (MACE) that was a 12-month combined endpoint of all-cause deaths, reinfarction or in-stent thrombosis, and target-lesion revascularization. The 12-month in-stent thrombosis was also evaluated to address the safety of Firebird SES implantation exceptionally. RESULTS: A total of 468 patients were assessed for eligibility. Of 113 patients who were finally included according to the prior inclusion and exclusion criteria, 39 (41 lesions) were treated with Firebird SES, 37 (39 lesions) with Cypher SES, and 37 (37 lesions) with BMS. There were no significant differences in the baseline characteristics between the three groups; but there were longer lesions, more frequent use of overlapping stent in the Firebird SES group and the Cypher SES group. Angiographic follow-up showed that the rates of binary stenosis were similar between the Firebird SES group and the Cypher SES group (in-segment: 14.6% vs 12.8%, relative risk (RR) 1.14, P = 0.81; in-stent: 9.8% vs 10.3%, RR 0.95, P = 0.94), and significantly lower than those in the BMS group (in-segment: vs. 36.1%, RR 0.41 or 0.36, P = 0.04 or 0.03, respectively; in-stent: vs 30.6%, RR 0.32 or 0.34, P = 0.03 or 0.04, respectively). The total MACE rate up to 12 months was also similar in both SES groups (7.7% vs 5.4%, P = 1.000), and significantly lower than that in the BMS group (27.0%, P = 0.034 or 0.024, respectively). The in-stent thrombosis rate in the follow-up period was 2.6% in the Firebird SES group, not higher in the Cypher SES and BMS groups (2.7% and 2.7%, respectively, P = 1.000). CONCLUSIONS: In the treatment of VLCL, Firebird SES would be safer and more effective than BMS. Firebird SES may be not inferior to Cypher SES in terms of restenosis and MACE. SN - 0366-6999 UR - https://www.unboundmedicine.com/medline/citation/18982862/Firebird_and_cypher_sirolimus_eluting_stents_and_bare_metal_stents_in_treatment_of_very_long_coronary_lesions_ L2 - http://Insights.ovid.com/pubmed?pmid=18982862 DB - PRIME DP - Unbound Medicine ER -