Safety and efficacy outcomes of overlapping second-generation everolimus-eluting stents versus first-generation drug-eluting stents.
Safety and efficacy outcomes of overlapping second-generation everolimus-eluting stents versus first-generation drug-eluting stents.
Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
The safety and efficacy outcomes of stent overlap with second-generation drug-eluting stents (DES) have not been well established. This study aimed to compare the 1-year clinical outcomes of overlapping everolimus-eluting stents (EES) with those of overlapping first-generation DES. This retrospective analysis included 350 patients treated with overlapping EES (169 patients with 237 lesions), sirolimus-eluting stents (SES, 102 patients with 252 lesions), or paclitaxel-eluting stents (PES, 79 patients with 182 lesions). End points were major adverse cardiovascular events (MACE: defined as the composite of death, myocardial infarction, or target lesion revascularization), target vessel revascularization, and definite stent thrombosis at 1 year. During a follow-up of 1 year, overall MACE occurred in 6.5% of EES-, 16.8% of SES-, and 10.1% of PES-treated patients (p = 0.026). Myocardial infarction was lowest in the EES group versus SES and PES groups (0 vs 1.0% vs 2.5%, respectively; p = 0.080), and mortality was similar (3.6% vs 9.0% vs 5.1%, p = 0.162). The EES patients showed a trend toward lower rates of 1-year target lesion revascularization (3.1% vs 8.2% vs 6.5%, p = 0.181) and target vessel revascularization (3.7% vs 9.1% vs 11.7%, p = 0.051) compared with the SES- and PES-treated patients. The cumulative incidence of definite stent thrombosis was lowest in the EES group (0 for EES vs 3.9% for SES vs 2.5% for PES, p = 0.014). In conclusion, stent overlap with EES versus first-generation DES was associated with lower rates of MACE and stent thrombosis. Our results suggest that the use of EES when deploying overlapping stents is effective and safe. Copyright 2013 Elsevier Inc. All rights reserved.
English
0002-9149
*Coronary Artery Disease/su [Surgery]
*Drug-Eluting Stents
*Immunosuppressive Agents/pd [Pharmacology]
*Paclitaxel/pd [Pharmacology]
*Sirolimus/aa [Analogs & Derivatives]
Aged
Antineoplastic Agents, Phytogenic/pd [Pharmacology]
District of Columbia/ep [Epidemiology]
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Postoperative Complications/ep [Epidemiology]
Prosthesis Design
Retrospective Studies
Sirolimus/pd [Pharmacology]
Treatment Outcome
MedStar Heart & Vascular Institute
Comparative Study
Journal Article
Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
The safety and efficacy outcomes of stent overlap with second-generation drug-eluting stents (DES) have not been well established. This study aimed to compare the 1-year clinical outcomes of overlapping everolimus-eluting stents (EES) with those of overlapping first-generation DES. This retrospective analysis included 350 patients treated with overlapping EES (169 patients with 237 lesions), sirolimus-eluting stents (SES, 102 patients with 252 lesions), or paclitaxel-eluting stents (PES, 79 patients with 182 lesions). End points were major adverse cardiovascular events (MACE: defined as the composite of death, myocardial infarction, or target lesion revascularization), target vessel revascularization, and definite stent thrombosis at 1 year. During a follow-up of 1 year, overall MACE occurred in 6.5% of EES-, 16.8% of SES-, and 10.1% of PES-treated patients (p = 0.026). Myocardial infarction was lowest in the EES group versus SES and PES groups (0 vs 1.0% vs 2.5%, respectively; p = 0.080), and mortality was similar (3.6% vs 9.0% vs 5.1%, p = 0.162). The EES patients showed a trend toward lower rates of 1-year target lesion revascularization (3.1% vs 8.2% vs 6.5%, p = 0.181) and target vessel revascularization (3.7% vs 9.1% vs 11.7%, p = 0.051) compared with the SES- and PES-treated patients. The cumulative incidence of definite stent thrombosis was lowest in the EES group (0 for EES vs 3.9% for SES vs 2.5% for PES, p = 0.014). In conclusion, stent overlap with EES versus first-generation DES was associated with lower rates of MACE and stent thrombosis. Our results suggest that the use of EES when deploying overlapping stents is effective and safe. Copyright 2013 Elsevier Inc. All rights reserved.
English
0002-9149
*Coronary Artery Disease/su [Surgery]
*Drug-Eluting Stents
*Immunosuppressive Agents/pd [Pharmacology]
*Paclitaxel/pd [Pharmacology]
*Sirolimus/aa [Analogs & Derivatives]
Aged
Antineoplastic Agents, Phytogenic/pd [Pharmacology]
District of Columbia/ep [Epidemiology]
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Postoperative Complications/ep [Epidemiology]
Prosthesis Design
Retrospective Studies
Sirolimus/pd [Pharmacology]
Treatment Outcome
MedStar Heart & Vascular Institute
Comparative Study
Journal Article