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Effectiveness of everolimus-eluting stents in the treatment of drug-eluting stent versus bare-metal stent restenosis.
Coron Artery Dis 2012; 23(7):492-6CA

Abstract

BACKGROUND

The efficacy of drug-eluting stents (DES) for the treatment of in-stent restenosis (ISR) after DES implantation is not well defined. This study compared the clinical outcome after the use of everolimus-eluting stents (EES) for the treatment of bare-metal stent (BMS) versus DES restenosis.

METHOD

Ninety-four patients with 94 ISR were included in this study. Sixty-four patients had BMS-ISR and 30 patients had DES-ISR. Patients were treated by repeat PCI using an EES. The primary endpoint of the study was survival free of target lesion revascularization (TLR) at 12 months or DES-ISR versus BMS-ISR patients. The secondary endpoints were survival free of major adverse cardiac events (MACE) and definite stent thrombosis.

RESULTS

The baseline clinical and angiographic parameters were comparable between the two groups. Treatment of DES-ISR was associated with higher rates of recurrent TLR, myocardial infarction (MI), and MACE at the 12-month follow-up compared with the treatment of BMS-ISR (23.3 versus 1.6%, P=0.002 for TLR; 13.3 versus 0%, P=0.017 for MI; and 30 versus 4.6%, P=0.003 for MACE). There were no differences in mortality and definite stent thrombosis between both groups (P=0.5686 and 0.6927, respectively). Initial stent number (odds ratio=1.13, 95% confidence interval 1.02-1.25; P=0.024) and initial stent type being a DES (odds ratio=8.11, 95% confidence interval 5.99-10.45; P<0.001) were independent predictors of recurrent TLR after the treatment of ISR using an EES.

CONCLUSION

EES used for the treatment of DES-ISR is associated with higher rates of recurrent revascularization, MI, and MACE compared with EES for the treatment of BMS-ISR.

Authors+Show Affiliations

Department of Cardiology, Medical Clinic I, University Hospital RWTH Aachen, Aachen, Germany.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22990414

Citation

Almalla, Mohammad, et al. "Effectiveness of Everolimus-eluting Stents in the Treatment of Drug-eluting Stent Versus Bare-metal Stent Restenosis." Coronary Artery Disease, vol. 23, no. 7, 2012, pp. 492-6.
Almalla M, Pross V, Marx N, et al. Effectiveness of everolimus-eluting stents in the treatment of drug-eluting stent versus bare-metal stent restenosis. Coron Artery Dis. 2012;23(7):492-6.
Almalla, M., Pross, V., Marx, N., & Hoffmann, R. (2012). Effectiveness of everolimus-eluting stents in the treatment of drug-eluting stent versus bare-metal stent restenosis. Coronary Artery Disease, 23(7), pp. 492-6.
Almalla M, et al. Effectiveness of Everolimus-eluting Stents in the Treatment of Drug-eluting Stent Versus Bare-metal Stent Restenosis. Coron Artery Dis. 2012;23(7):492-6. PubMed PMID: 22990414.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of everolimus-eluting stents in the treatment of drug-eluting stent versus bare-metal stent restenosis. AU - Almalla,Mohammad, AU - Pross,Verena, AU - Marx,Nikolaus, AU - Hoffmann,Rainer, PY - 2012/9/20/entrez PY - 2012/9/20/pubmed PY - 2013/2/28/medline SP - 492 EP - 6 JF - Coronary artery disease JO - Coron. Artery Dis. VL - 23 IS - 7 N2 - BACKGROUND: The efficacy of drug-eluting stents (DES) for the treatment of in-stent restenosis (ISR) after DES implantation is not well defined. This study compared the clinical outcome after the use of everolimus-eluting stents (EES) for the treatment of bare-metal stent (BMS) versus DES restenosis. METHOD: Ninety-four patients with 94 ISR were included in this study. Sixty-four patients had BMS-ISR and 30 patients had DES-ISR. Patients were treated by repeat PCI using an EES. The primary endpoint of the study was survival free of target lesion revascularization (TLR) at 12 months or DES-ISR versus BMS-ISR patients. The secondary endpoints were survival free of major adverse cardiac events (MACE) and definite stent thrombosis. RESULTS: The baseline clinical and angiographic parameters were comparable between the two groups. Treatment of DES-ISR was associated with higher rates of recurrent TLR, myocardial infarction (MI), and MACE at the 12-month follow-up compared with the treatment of BMS-ISR (23.3 versus 1.6%, P=0.002 for TLR; 13.3 versus 0%, P=0.017 for MI; and 30 versus 4.6%, P=0.003 for MACE). There were no differences in mortality and definite stent thrombosis between both groups (P=0.5686 and 0.6927, respectively). Initial stent number (odds ratio=1.13, 95% confidence interval 1.02-1.25; P=0.024) and initial stent type being a DES (odds ratio=8.11, 95% confidence interval 5.99-10.45; P<0.001) were independent predictors of recurrent TLR after the treatment of ISR using an EES. CONCLUSION: EES used for the treatment of DES-ISR is associated with higher rates of recurrent revascularization, MI, and MACE compared with EES for the treatment of BMS-ISR. SN - 1473-5830 UR - https://www.unboundmedicine.com/medline/citation/22990414/Effectiveness_of_everolimus_eluting_stents_in_the_treatment_of_drug_eluting_stent_versus_bare_metal_stent_restenosis_ L2 - http://dx.doi.org/10.1097/MCA.0b013e328358a58f DB - PRIME DP - Unbound Medicine ER -