Clinical Outcomes for Sirolimus-Eluting Stents and Polymer-Coated Paclitaxel-Eluting Stents in Daily Practice
| Autor: | Fabio Tarantino, Giuseppe Geraci, Paolo Guastaroba, Francesco Saia, Giancarlo Piovaccari, Andrea Santarelli, Antonio Marzocchi, Giuseppe Vecchi, Roberto Grilli, Pietro Sangiorgio, Alberto Benassi, Enrico Aurier, Antonio Manari |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
medicine.medical_specialty
education.field_of_study business.industry medicine.medical_treatment Hazard ratio Population medicine.disease Confidence interval Surgery Drug-eluting stent Internal medicine medicine Cardiology Cumulative incidence Myocardial infarction Cardiology and Cardiovascular Medicine Prospective cohort study education business Mace |
| Zdroj: | Journal of the American College of Cardiology. 48:1312-1318 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2006.03.063 |
| Popis: | OBJECTIVES We compared the clinical outcome of sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) in a real-world scenario. BACKGROUND In selected patients, SES has been associated with lower late luminal loss than PES. Whether this emerging biological difference could translate into different clinical efficacy in daily practice is presently unknown. METHODS This analysis included 1,676 consecutive patients with de novo coronary lesions treated solely with drug-eluting stents (SES = 992; PES = 684). All patients were enrolled in a dynamic prospective registry comprising 13 hospitals. We assessed the cumulative incidence of major adverse cardiac events (MACE), defined as death, myocardial infarction (MI), and target vessel revascularization (TVR) during follow-up. RESULTS Overall, 29% of the patients had diabetes, 23% had prior MI, and 9% had poor left ventricular function. ST-segment elevation MI was diagnosed at admission in 12%. Multivessel intervention was performed in 16%. At 1-year follow-up, SES was associated with a reduced incidence of MACE (9.2% SES vs. 14.1% PES; p = 0.007) and TVR (5.0% SES vs. 10.0% PES; p = 0.0008) compared to PES. A propensity analysis with many clinical and angiographic variables was carried out to adjust for baseline differences. In this analysis, SES was associated with a 44% risk reduction of MACE (hazard ratio 0.56, 95% confidence interval 0.39 to 0.78) and a 55% reduction of TVR (hazard ratio 0.45, 95% confidence interval 0.29 to 0.70). This result was consistent across most subgroups tested. Similar rates of death and MI were observed in the 2 treatment groups. CONCLUSIONS In this large real-world population, SES improved 1-year clinical results as compared to PES. |
| Databáze: | OpenAIRE |
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