Second-generation everolimus-eluting stents compared to first-generation drug-eluting stents in patients treated for multivessel disease.

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Citation: Journal of Interventional Cardiology. 26(6):561-9, 2013 Dec.PMID: 24028183Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Comparative Study | Journal ArticleSubject headings: *Coronary Disease/th [Therapy] | *Drug-Eluting Stents | *Sirolimus/aa [Analogs & Derivatives] | Aged | Coronary Angiography | Coronary Disease/co [Complications] | Female | Humans | Male | Sirolimus/ad [Administration & Dosage] | Treatment OutcomeYear: 2013ISSN:
  • 0896-4327
Name of journal: Journal of interventional cardiologyAbstract: BACKGROUND: Second-generation EES have demonstrated superiority over first-generation DES for single-vessel disease, although the merits of EES in MVD are less established.CONCLUSIONS: The use of EES in patients with MVD is safe with signals for improved effectiveness compared to first-generation DES. Randomized trials comparing new-generation DES to coronary artery bypass grafting surgery are warranted.Copyright � 2013, Wiley Periodicals, Inc.METHODS: A cohort of 1, 285 patients (3, 124 lesions) with > 2 diseased vessels were treated with either first-generation DES (n=1, 002) or EES (n=283). The rates of death, myocardial infarction, target lesion revascularization, target vessel revascularization, definite stent thrombosis, and major adverse cardiac events (MACE), defined as the combined incidence of target vessel revascularization, death, and non-fatal myocardial infarction, were compared at 1 year.OBJECTIVE: This study aimed to compare the safety and efficacy of everolimus-eluting stents (EES) to first-generation drug-eluting stents (DES) in multivessel disease (MVD).RESULTS: Baseline characteristics were similar except for a lower left ventricular ejection fraction and a lower incidence of stable angina pectoris in the first-generation DES group (P=0.001 and 0.013, respectively). At 1 year, the MACE rate was lower in the EES group (9.5P% vs. 15.7%; P=0.01). Multivariable analysis demonstrated that EES use predicted a higher chance of freedom from MACE at 1 year (hazard ratio 0.58 [0.38-0.87]; P=0.009; 95% confidence interval).All authors: Badr S, Barbash IM, Dvir D, Kitabata H, Loh JP, Minha S, Pendyala LK, Pichard AD, Torguson R, Waksman RFiscal year: FY2014Digital Object Identifier: Date added to catalog: 2015-03-17
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Journal Article MedStar Authors Catalog Article 24028183 Available 24028183

BACKGROUND: Second-generation EES have demonstrated superiority over first-generation DES for single-vessel disease, although the merits of EES in MVD are less established.

CONCLUSIONS: The use of EES in patients with MVD is safe with signals for improved effectiveness compared to first-generation DES. Randomized trials comparing new-generation DES to coronary artery bypass grafting surgery are warranted.Copyright � 2013, Wiley Periodicals, Inc.

METHODS: A cohort of 1, 285 patients (3, 124 lesions) with > 2 diseased vessels were treated with either first-generation DES (n=1, 002) or EES (n=283). The rates of death, myocardial infarction, target lesion revascularization, target vessel revascularization, definite stent thrombosis, and major adverse cardiac events (MACE), defined as the combined incidence of target vessel revascularization, death, and non-fatal myocardial infarction, were compared at 1 year.

OBJECTIVE: This study aimed to compare the safety and efficacy of everolimus-eluting stents (EES) to first-generation drug-eluting stents (DES) in multivessel disease (MVD).

RESULTS: Baseline characteristics were similar except for a lower left ventricular ejection fraction and a lower incidence of stable angina pectoris in the first-generation DES group (P=0.001 and 0.013, respectively). At 1 year, the MACE rate was lower in the EES group (9.5P% vs. 15.7%; P=0.01). Multivariable analysis demonstrated that EES use predicted a higher chance of freedom from MACE at 1 year (hazard ratio 0.58 [0.38-0.87]; P=0.009; 95% confidence interval).

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