Abstract 5987: Long-Term Efficacy and Safety of Sirolimus-Eluting Versus Bare-Metal Stents for On- and Off-Label Indications
| Autor: | Marcin R Dada, Francis J Kiernan, Deborah J Murphy, Jill Cloutier, Athanasios Kapetanopoulos, Bhupinder Singh, Rameez Sayyed, Jeffrey F Mather, Roger A Mennett, Anuj R Shah, Raymond G McKay |
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| Rok vydání: | 2008 |
| Předmět: | |
| Zdroj: | Circulation. 118 |
| ISSN: | 1524-4539 0009-7322 |
| DOI: | 10.1161/circ.118.suppl_18.s_1040-a |
| Popis: | BACKGROUND: Although previous data suggest persistent clinical benefit of sirolimus-eluting stents (SES) in reducing target vessel revascularization without an increase in myocardial infarction (MI), cumulative stent thrombosis and mortality, the long-term safety and efficacy of CYPHER stent use in routine clinical practice, including off-label stent implantation, remains uncertain. METHODS: We examined clinical characteristics, angiographic findings, in hospital and long-term clinical outcomes in 3572 patients of whom 2,550 were treated with SES, and 1,022 who were treated with bare metal or heparin-coated stents (BMS). The study groups included 1,058 SES patients (41.5%) and 488 BMS patients (47.7%) with off-label indications, including acute MI, multivessel percutaneous coronary intervention, saphenous vein grafts and complex lesion morphology. A propensity-score method was utilized to adjust for differences in baseline characteristics. Patients were followed for up to 5 years for the occurrence of all-cause mortality, MI and repeat target vessel revascularization. RESULTS: Compared to the BMS patients, the SES group patients demonstrated significantly improved event-free survival with respect to all-cause mortality (RR, 1.39; 95% CI, 1.07 to 1.80, p=0.014) and repeat target vessel revascularization (RR, 2.72; 95% CI, 1.99 to 3.73, p CONCLUSIONS : Use of SES in routine clinical practice, including off-label indications, is associated with improved long-term mortality, reduced need for repeat target vessel revascularization and no increase in MI compared to BMS. |
| Databáze: | OpenAIRE |
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