Drug-eluting stents versus bare-metal stents for treatment of bare-metal in-stent restenosis

Autor: A. Michael Lincoff, Stephen G. Ellis, Steven J. Filby, Inder M. Singh, Mehdi H. Shishehbor, Eiran Z. Gorodeski, Fredy El Sakr
Rok vydání: 2010
Předmět:
Male
Drug
medicine.medical_specialty
Time Factors
media_common.quotation_subject
medicine.medical_treatment
Myocardial Infarction
Kaplan-Meier Estimate
Coronary Angiography
Prosthesis Design
Revascularization
Risk Assessment
Article
Coronary Restenosis
Restenosis
Risk Factors
Humans
Medicine
Bare metal
Radiology
Nuclear Medicine and imaging
Registries
cardiovascular diseases
Angioplasty
Balloon
Coronary
Aged
Ohio
Proportional Hazards Models
Retrospective Studies
media_common
Chi-Square Distribution
business.industry
digestive
oral
and skin physiology
Drug-Eluting Stents
General Medicine
Middle Aged
equipment and supplies
medicine.disease
Surgery
stomatognathic diseases
Vascular brachytherapy
Treatment Outcome
surgical procedures
operative
Metals
Female
Stents
Radiology
In stent restenosis
Cardiology and Cardiovascular Medicine
business
Zdroj: Catheterization and Cardiovascular Interventions. 76:257-262
ISSN: 1522-726X
1522-1946
DOI: 10.1002/ccd.22509
Popis: We compared the long-term outcomes of drug-eluting stents (DES) versus bare-metal stents (BMS) for treatment of bare-metal in-stent restenosis (ISR).There are no randomized trials or observational studies directly comparing the safety and efficacy of DES versus BMS for treatment of bare-metal ISR.We examined data on all patients who underwent percutaneous coronary intervention (PCI) for ISR at Cleveland Clinic between 05/1999 and 06/2007. We compared the efficacy and safety of DES to BMS for treating bare-metal ISR. The primary end point was a composite of death, myocardial infarction (MI), or target lesion revascularization (TLR). The secondary endpoints were individual components of the primary endpoint.Of the 931 patients identified over 8 years, 706 had bare-metal ISR and met our study criteria. Of the 706 patients with bare-metal ISR, 362 were treated with DES and 344 with BMS. There were 230 cumulative events for a median follow-up of 3.2 years. After adjusting for 27 variables, DES were associated with lower primary endpoint compared to BMS for treatment of bare-metal ISR (21% vs. 45%, adjusted hazard ratio [HR] 0.63; 95% confidence interval [CI], 0.42-0.95; P = 0.03). The individual secondary endpoint of death (8% vs. 24%, P = 0.005) favored DES, but MI (3% vs. 8%, P = 0.31), and TLR (13% vs. 20%, P = 0.23) failed to reach statistical significance.In our multivariate analysis of patients with bare-metal ISR, DES use was associated with significantly lower death, MI, or TLR when compared to BMS.
Databáze: OpenAIRE
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