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Safety and efficacy of everolimus-eluting stents for bare-metal in-stent restenosis

Safety and efficacy of everolimus-eluting stents for bare-metal in-stent restenosis
Safety and efficacy of everolimus-eluting stents for bare-metal in-stent restenosis
OBJECTIVE: The aim of this study was to compare the safety and efficacy of the everolimus-eluting stents (EES) with the paclitaxel-eluting stent (PES) and sirolimus-eluting stent (SES) for the treatment of bare-metal in-stent restenosis.

BACKGROUND: The optimal treatment for bare-metal in-stent restenosis remains controversial.

METHODS: The study cohort comprised 322 consecutive patients (543 lesions) who presented with bare-metal in-stent restenosis to our institution and underwent coronary artery stent implantation with EES (114 patients; 181 lesions), PES (65 patients; 116 lesions) and SES (143 patients; 246 lesions). The analyzed clinical parameters were the 1-year rates of death, Q-wave myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), definite stent thrombosis (ST) and major adverse cardiac events (MACE) defined as the composite of death, MI, or TLR at 1-year.

RESULTS: The three groups were well matched for the conventional risk factors except for age and chronic kidney disease. The 1-year analyzed clinical parameters were similar in the three groups: death (EES=3.5%, PES=4.6%, SES=4.2%; p=0.94), MI (EES=3.5%, PES=6.3%, SES=2.1%; p=0.31), TLR (EES=9.8%, PES=9.5%, SES=5.7%; p=0.42), TVR (EES=14.3%, PES=11.1%, SES=11.3%; p=0.74), definite ST (EES=0.9%, PES=3.1%, SES=3.5%; p=0.38) and MACE (EES=14.0%, PES=15.4%, SES=10.5%; p=0.54). Male gender (hazard ratio=0.47; 95% confidence interval=0.25-0.88) and number of treated lesions (hazard ratio=1.47; 95% confidence interval=1.06-2.05) were found to be independent predictors of MACE.

CONCLUSION: The results of the present study indicate that EES may provide similar safety and efficacy as first generation DES for the treatment of patients presenting with bare-metal in-stent restenosis.
1553-8389
151-155
Ota, Hideaki
14f81e1f-4ac6-451e-9d72-13b48099298a
Mahmoudi, Michael
f6a55246-399e-4f81-944e-a4b169786e8a
Torguson, Rebecca
2fc1ca2f-5f09-47bc-8749-4297680de611
Satler, Lowell F.
ca752a0b-53b4-4107-a30b-a7b42167112a
Suddath, William O.
0768302d-bb8c-4522-8986-7364b4d41ad2
Pichard, Augusto D.
d2f75f00-aca0-4897-8758-08d0b2e57beb
Waksman, Ron
23d6bf65-0556-4930-8fad-224a559b34e0
Ota, Hideaki
14f81e1f-4ac6-451e-9d72-13b48099298a
Mahmoudi, Michael
f6a55246-399e-4f81-944e-a4b169786e8a
Torguson, Rebecca
2fc1ca2f-5f09-47bc-8749-4297680de611
Satler, Lowell F.
ca752a0b-53b4-4107-a30b-a7b42167112a
Suddath, William O.
0768302d-bb8c-4522-8986-7364b4d41ad2
Pichard, Augusto D.
d2f75f00-aca0-4897-8758-08d0b2e57beb
Waksman, Ron
23d6bf65-0556-4930-8fad-224a559b34e0

Ota, Hideaki, Mahmoudi, Michael, Torguson, Rebecca, Satler, Lowell F., Suddath, William O., Pichard, Augusto D. and Waksman, Ron (2015) Safety and efficacy of everolimus-eluting stents for bare-metal in-stent restenosis. Cardiovascular Revascularization Medicine, 16 (3), 151-155. (doi:10.1016/j.carrev.2015.02.005). (PMID:25977226)

Record type: Article

Abstract

OBJECTIVE: The aim of this study was to compare the safety and efficacy of the everolimus-eluting stents (EES) with the paclitaxel-eluting stent (PES) and sirolimus-eluting stent (SES) for the treatment of bare-metal in-stent restenosis.

BACKGROUND: The optimal treatment for bare-metal in-stent restenosis remains controversial.

METHODS: The study cohort comprised 322 consecutive patients (543 lesions) who presented with bare-metal in-stent restenosis to our institution and underwent coronary artery stent implantation with EES (114 patients; 181 lesions), PES (65 patients; 116 lesions) and SES (143 patients; 246 lesions). The analyzed clinical parameters were the 1-year rates of death, Q-wave myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), definite stent thrombosis (ST) and major adverse cardiac events (MACE) defined as the composite of death, MI, or TLR at 1-year.

RESULTS: The three groups were well matched for the conventional risk factors except for age and chronic kidney disease. The 1-year analyzed clinical parameters were similar in the three groups: death (EES=3.5%, PES=4.6%, SES=4.2%; p=0.94), MI (EES=3.5%, PES=6.3%, SES=2.1%; p=0.31), TLR (EES=9.8%, PES=9.5%, SES=5.7%; p=0.42), TVR (EES=14.3%, PES=11.1%, SES=11.3%; p=0.74), definite ST (EES=0.9%, PES=3.1%, SES=3.5%; p=0.38) and MACE (EES=14.0%, PES=15.4%, SES=10.5%; p=0.54). Male gender (hazard ratio=0.47; 95% confidence interval=0.25-0.88) and number of treated lesions (hazard ratio=1.47; 95% confidence interval=1.06-2.05) were found to be independent predictors of MACE.

CONCLUSION: The results of the present study indicate that EES may provide similar safety and efficacy as first generation DES for the treatment of patients presenting with bare-metal in-stent restenosis.

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More information

Accepted/In Press date: 20 February 2015
e-pub ahead of print date: 26 February 2015
Published date: April 2015
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 394527
URI: http://eprints.soton.ac.uk/id/eprint/394527
ISSN: 1553-8389
PURE UUID: 909f2c38-61c1-4c79-9e59-7bdf8b357ccc
ORCID for Michael Mahmoudi: ORCID iD orcid.org/0000-0003-1293-8461

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Date deposited: 20 May 2016 08:39
Last modified: 15 Mar 2024 03:54

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Contributors

Author: Hideaki Ota
Author: Rebecca Torguson
Author: Lowell F. Satler
Author: William O. Suddath
Author: Augusto D. Pichard
Author: Ron Waksman

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