Propensity score matched all comers population treated with ultra-thin strut bare metal and sirolimus-probucol coated drug-eluting stents of identical stent architecture
Autor: | Maxime Pons, André Schneider, Behrouz Kherad, Christian Sperling, Matthias Leschke, Matthias Waliszewski, Pedro Jerónimo Sousa, Florian Krackhardt, Tay Mok Heang, Mohd Ali Rosli |
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Rok vydání: | 2017 |
Předmět: |
Male
Time Factors medicine.medical_treatment Coronary Artery Disease 030204 cardiovascular system & hematology law.invention Postoperative Complications 0302 clinical medicine Randomized controlled trial Risk Factors law Clinical endpoint Prospective Studies Registries 030212 general & internal medicine Myocardial infarction Aged 80 and over education.field_of_study Drug-Eluting Stents General Medicine Middle Aged Europe Treatment Outcome Metals Drug-eluting stent Female Cardiology and Cardiovascular Medicine medicine.drug medicine.medical_specialty Asia Population Prosthesis Design Risk Assessment 03 medical and health sciences Percutaneous Coronary Intervention medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Propensity Score education Aged Sirolimus business.industry Stent Cardiovascular Agents medicine.disease Surgery Probucol business Mace |
Zdroj: | Catheterization and Cardiovascular Interventions. 91:1221-1228 |
ISSN: | 1522-1946 |
Popis: | Objective The objective of this study was to compare the safety and efficacy of a polymer-free sirolimus coated, ultrathin strut drug eluting stent (PF-SES) to its uncoated bare-metal stent (BMS) platform of identical stent architecture. Background Recently published randomized trials comparing BMS to DES with a focus on shortened dual-antiplatelet therapy reported incidences of stent thrombosis (ST) and bleeding complications (LEADERS FREE) in favor of drug eluting stents (DES). Methods Data of previously published large-sale, international, single-armed, multicenter, observational studies of ultra-thin PF-SES, and BMS were propensity score (PS) matched for selected lesion morphological and cardiovascular risk factors to compare target lesion revascularization (TLR), myocardial infarction, cardiac death, major adverse cardiac events (MACE), bleeding complications and ST rates. Primary endpoint in both studies was TLR at 9 months. Results At 9 months the rates of TLR was significantly lower in the PF-SES group as compared with patients treated with the BMS analogue of identical stent design (1.4% vs. 4.6%, P = 0.005). Likewise the 9-month MACE rates were lower in the PF-SES group (3.2% vs. 8.7%, P = 0.001) whereas there were no differences in the accumulated ST rates (0.5% vs. 1.5%, P = 0.109). Overall accumulated bleeding incidences (BARC 1–5) were not significantly different between PF-SES and BMS patients (1.8% vs. 2.7%, p = 0.388). Conclusions PF-SES are superior over analogue BMS of identical stent architecture in daily clinical routine with lower rates of TLR and MACE in a PS-matched, unselected patient population without differences in accumulated ST rates and bleeding frequencies given the currently favored postprocedural comedication (ClinicalTrials.gov Identifier NCT02629575). |
Databáze: | OpenAIRE |
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