Drug-Eluting or Bare-Metal Stents for Coronary Artery Disease
| Autor: | Kaare H. Bønaa, Nils-Einar Kløw, Knut Rasmussen, A.I Larsen, Rune Wiseth, Øyvind Bleie, Yngvar Myreng, Jan Mannsverk, Inger Njølstad, Sindre Stavnes, Reidar Bjørnerheim, Thor Trovik, Ottar Nygård, Morten Slette, Norstent Investigators, Terje K. Steigen, Øystein Dahl-Eriksen, Eigil Fossum, Dennis W.T. Nilsen, Tom Wilsgaard, Ole J Jakobsen, Bjørn Bendz, Michael Uchto, Tove Aminda Hanssen, Jan Erik Nordrehaug, Lars Aaberge |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Myocardial Infarction Coronary Artery Disease Kaplan-Meier Estimate 030204 cardiovascular system & hematology law.invention Coronary artery disease 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Angioplasty Internal medicine Myocardial Revascularization medicine Humans Everolimus cardiovascular diseases 030212 general & internal medicine Myocardial infarction Angioplasty Balloon Coronary Aged Sirolimus business.industry Hazard ratio Percutaneous coronary intervention Drug-Eluting Stents General Medicine Middle Aged equipment and supplies medicine.disease Surgery surgical procedures operative Retreatment Conventional PCI Cardiology Female Stents business Follow-Up Studies medicine.drug |
| Zdroj: | New England Journal of Medicine. 375:1242-1252 |
| ISSN: | 1533-4406 0028-4793 |
| Popis: | Limited data are available on the long-term effects of contemporary drug-eluting stents versus contemporary bare-metal stents on rates of death, myocardial infarction, repeat revascularization, and stent thrombosis and on quality of life.We randomly assigned 9013 patients who had stable or unstable coronary artery disease to undergo percutaneous coronary intervention (PCI) with the implantation of either contemporary drug-eluting stents or bare-metal stents. In the group receiving drug-eluting stents, 96% of the patients received either everolimus- or zotarolimus-eluting stents. The primary outcome was a composite of death from any cause and nonfatal spontaneous myocardial infarction after a median of 5 years of follow-up. Secondary outcomes included repeat revascularization, stent thrombosis, and quality of life.At 6 years, the rates of the primary outcome were 16.6% in the group receiving drug-eluting stents and 17.1% in the group receiving bare-metal stents (hazard ratio, 0.98; 95% confidence interval [CI], 0.88 to 1.09; P=0.66). There were no significant between-group differences in the components of the primary outcome. The 6-year rates of any repeat revascularization were 16.5% in the group receiving drug-eluting stents and 19.8% in the group receiving bare-metal stents (hazard ratio, 0.76; 95% CI, 0.69 to 0.85; P0.001); the rates of definite stent thrombosis were 0.8% and 1.2%, respectively (P=0.0498). Quality-of-life measures did not differ significantly between the two groups.In patients undergoing PCI, there were no significant differences between those receiving drug-eluting stents and those receiving bare-metal stents in the composite outcome of death from any cause and nonfatal spontaneous myocardial infarction. Rates of repeat revascularization were lower in the group receiving drug-eluting stents. (Funded by the Norwegian Research Council and others; NORSTENT ClinicalTrials.gov number, NCT00811772 .). |
| Databáze: | OpenAIRE |
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