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Four-year clinical outcome of sirolimus- and paclitaxel-eluting stents compared to bare-metal stents for the percutaneous treatment of stable coronary artery disease.
Catheter Cardiovasc Interv. 2010 Jul 01; 76(1):41-9.CC

Abstract

BACKGROUND

There are limited data on the long-term safety and efficacy profile of coronary stent implantation in patients with stable coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI).

OBJECTIVE

We aimed to assess the 4-year clinical outcome in patients who received a bare-metal stent (BMS), sirolimus-eluting stent (SES), or a paclitaxel-eluting stent (PES) for the percutaneous treatment of stable angina in our center during 2000-2005.

METHODS

In the study period, a total of 2,449 consecutive patients (BMS = 1,005; SES = 373; and PES = 1071) underwent a PCI as part of three historical PCI-cohorts for stable angina and were routinely followed for the occurrence of major adverse cardiac events (MACE).

RESULTS

At 4 years follow-up, 264 BMS patients (26.8%) had a MACE, compared to 75 SES patients (20.9%) and 199 PES patients (23.9%). Multivariate analysis showed that SES and PES were superior to BMS with respect to MACE [hazard ratio (HR) = 0.62, 95% confidence interval (CI): 0.47-0.81; HR = 0.67, 95% CI: 0.55-0.82, respectively]. The occurrence of MACE was significantly lower in the SES and PES population, primarily due to less target-vessel revascularization (TVR) procedures (HR = 0.53, 95% CI: 0.37-0.75; HR = 0.71, 95% CI: 0.62-0.81, respectively). The occurrence of early, late, and very late stent thrombosis was equally rare with each stent type. There were no significant differences between SES and PES on death, myocardial infarction, TVR, and MACE.

CONCLUSION

These findings suggest that SES and PES result in decreased TVR procedures and MACE compared to BMS at 4 years follow-up. SES or PES implantation should be the preferred choice over BMS for patients with stable CAD undergoing PCI.

Authors+Show Affiliations

Department of Cardiology, Thoraxcenter, Erasmus Medical Center Rotterdam, Dr. Molewaterplein 40, Rotterdam, The Netherlands. p.w.j.c.serruys@erasmusmc.nlNo 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

20310019

Citation

Simsek, Cihan, et al. "Four-year Clinical Outcome of Sirolimus- and Paclitaxel-eluting Stents Compared to Bare-metal Stents for the Percutaneous Treatment of Stable Coronary Artery Disease." Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, vol. 76, no. 1, 2010, pp. 41-9.
Simsek C, Onuma Y, Magro M, et al. Four-year clinical outcome of sirolimus- and paclitaxel-eluting stents compared to bare-metal stents for the percutaneous treatment of stable coronary artery disease. Catheter Cardiovasc Interv. 2010;76(1):41-9.
Simsek, C., Onuma, Y., Magro, M., de Boer, S., Battes, L., van Domburg, R. T., Boersma, E., & Serruys, P. W. (2010). Four-year clinical outcome of sirolimus- and paclitaxel-eluting stents compared to bare-metal stents for the percutaneous treatment of stable coronary artery disease. Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, 76(1), 41-9. https://doi.org/10.1002/ccd.22533
Simsek C, et al. Four-year Clinical Outcome of Sirolimus- and Paclitaxel-eluting Stents Compared to Bare-metal Stents for the Percutaneous Treatment of Stable Coronary Artery Disease. Catheter Cardiovasc Interv. 2010 Jul 1;76(1):41-9. PubMed PMID: 20310019.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Four-year clinical outcome of sirolimus- and paclitaxel-eluting stents compared to bare-metal stents for the percutaneous treatment of stable coronary artery disease. AU - Simsek,Cihan, AU - Onuma,Yoshinobu, AU - Magro,Michael, AU - de Boer,Sanneke, AU - Battes,Linda, AU - van Domburg,Ron T, AU - Boersma,Eric, AU - Serruys,Patrick W, AU - ,, PY - 2010/3/24/entrez PY - 2010/3/24/pubmed PY - 2010/10/16/medline SP - 41 EP - 9 JF - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JO - Catheter Cardiovasc Interv VL - 76 IS - 1 N2 - BACKGROUND: There are limited data on the long-term safety and efficacy profile of coronary stent implantation in patients with stable coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). OBJECTIVE: We aimed to assess the 4-year clinical outcome in patients who received a bare-metal stent (BMS), sirolimus-eluting stent (SES), or a paclitaxel-eluting stent (PES) for the percutaneous treatment of stable angina in our center during 2000-2005. METHODS: In the study period, a total of 2,449 consecutive patients (BMS = 1,005; SES = 373; and PES = 1071) underwent a PCI as part of three historical PCI-cohorts for stable angina and were routinely followed for the occurrence of major adverse cardiac events (MACE). RESULTS: At 4 years follow-up, 264 BMS patients (26.8%) had a MACE, compared to 75 SES patients (20.9%) and 199 PES patients (23.9%). Multivariate analysis showed that SES and PES were superior to BMS with respect to MACE [hazard ratio (HR) = 0.62, 95% confidence interval (CI): 0.47-0.81; HR = 0.67, 95% CI: 0.55-0.82, respectively]. The occurrence of MACE was significantly lower in the SES and PES population, primarily due to less target-vessel revascularization (TVR) procedures (HR = 0.53, 95% CI: 0.37-0.75; HR = 0.71, 95% CI: 0.62-0.81, respectively). The occurrence of early, late, and very late stent thrombosis was equally rare with each stent type. There were no significant differences between SES and PES on death, myocardial infarction, TVR, and MACE. CONCLUSION: These findings suggest that SES and PES result in decreased TVR procedures and MACE compared to BMS at 4 years follow-up. SES or PES implantation should be the preferred choice over BMS for patients with stable CAD undergoing PCI. SN - 1522-726X UR - https://www.unboundmedicine.com/medline/citation/20310019/Four_year_clinical_outcome_of_sirolimus__and_paclitaxel_eluting_stents_compared_to_bare_metal_stents_for_the_percutaneous_treatment_of_stable_coronary_artery_disease_ L2 - https://doi.org/10.1002/ccd.22533 DB - PRIME DP - Unbound Medicine ER -