Clinical Outcomes for Sirolimus-Eluting Stents and Polymer-Coated Paclitaxel-Eluting Stents in Daily Practice

Saia, Francesco; Piovaccari, Giancarlo; Manari, Antonio; Santarelli, Andrea; Benassi, Alberto; Aurier, E; Sangiorgio, Pietro; Tarantino, Fabio; Geraci, Giuseppe; Vecchi, Giuseppe; Guastaroba, Paolo; Grilli, Roberto; Marzocchi, Antonío

doi:10.1016/j.jacc.2006.03.063

Cited by 41 publications

(34 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…5,6 Other issues that should be considered in patients with DES implants are late thrombosis in a small but significant number of patients 7-9 and the need for prolonged dual antiplatelet therapy.…”

Section: There Have Been Attempts To Find New Approaches To the Treatmentioning

confidence: 99%

“…[1][2][3][4] However, the benefit of the DES appears to be confined to lowering the risks of repeat interventions, because mortality rates and the risk of myocardial infarction (MI) have not been lessened by the DES. 5,6 Other issues that should be considered in patients with DES implants are late thrombosis in a small but significant number of patients [7][8][9] and the need for prolonged dual antiplatelet therapy.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Selective versus Exclusive Use of Drug-Eluting Stents in Treating Multivessel Coronary Artery Disease: A Real-World Cohort Study

Karbassi¹,

Kassaian²,

Poorhosseini³

et al. 2014

Texas Heart Institute Journal

View full text Add to dashboard Cite

There have been attempts to find new approaches to the treatment of multivessel coro nary artery disease without increasing adverse events. Deployment of drugeluting stents (DES) for complex lesions and baremetal stents (BMST he drug-eluting stent (DES), in comparison with the bare-metal stent (BMS), has been associated with a reduction both in the incidence of restenosis and in the need for repeat interventions.1-4 However, the benefit of the DES appears to be confined to lowering the risks of repeat interventions, because mortality rates and the risk of myocardial infarction (MI) have not been lessened by the DES. 5,6 Other issues that should be considered in patients with DES implants are late thrombosis in a small but significant number of patients 7-9 and the need for prolonged dual antiplatelet therapy.In multivessel percutaneous coronary intervention (PCI), there have been attempts to find new approaches to revascularization in an effort to minimize cost, late thrombosis, and the risk of early discontinuation of dual antiplatelet therapy. These considerations have led to the development of a practice in which DES is used for complex, high-risk lesions and BMS for simple and low-risk lesions, even in the same patient. 10Although this approach already has been applied in the real world, its outcome has yet to be fully evaluated.The aim of this study was to investigate the clinical impact of the DES when used in combination with the BMS in the percutaneous treatment of multivessel coronary artery disease (CAD). We compared the results of 3 different approaches in the

show abstract

Section: There Have Been Attempts To Find New Approaches To the Treatmentioning

confidence: 99%

mentioning

confidence: 99%

Selective versus Exclusive Use of Drug-Eluting Stents in Treating Multivessel Coronary Artery Disease: A Real-World Cohort Study

Karbassi¹,

Kassaian²,

Poorhosseini³

et al. 2014

Texas Heart Institute Journal

View full text Add to dashboard Cite

show abstract

“…In randomized head-to-head comparisons, SES has been consistently associated with superior suppression of neointimal hyperplasia compared to PES. [34][35][36] However, the reduction of in-stent and in-segment late loss was not always paralleled by a reduction of binary restenosis, need for repeat revascularization, and MACE. 34,35) Consistent with our finding are several studies, including the larger multicenter REALITY trial, 34) where neither binary restenosis nor MACE and TVR rates were reduced by the SES as compared to the PES.…”

Section: Figurementioning

confidence: 99%

“…Another study showed less need for revascularization with SES. 36) Study limitations: As an observational study, we fully expected a selection bias between CCS and DES-treated patients because our primary goal was to describe usage patterns unconstrained by eligibility criteria. Furthermore, we cannot extrapolate our practice and study results to all centers in the country.…”

Section: Figurementioning

confidence: 99%

Cobalt Chromium Coronary Stents and Drug-Eluting Stents in Real Practice

Youssef

Hussein²,

Hsueh

et al. 2010

Int. Heart J.

View full text Add to dashboard Cite

SummaryCobalt chromium stents (CCS) are seldom compared to drug-eluting stents (DES) for coronary intervention in published clinical trials. We evaluated the daily usage patterns of CCS in comparison to DES unconstrained by eligibility criteria. We compared consecutive patients (n = 303) with de novo lesions treated exclusively with a CCS to 432 patients treated exclusively with a DES. Patients in the CCS group were older, frequently had heart failure, renal failure, prior coronary balloon angioplasty, prior stroke, more comorbidities, and more multivessel disease than the DES group. The DES group had longer and more type C and left anterior descending (LAD) coronary artery lesions. The in-hospital major adverse cardiac events (MACE; death, myocardial infarction, stroke and target lesion revascularization (TLR)) were similar. At 6 months, the cumulative rate of MACE was 12.9% in the CCS group and 5.6% in the DES group (P < 0.001), and this was driven by TLR. The rates of stent thrombosis were similar in CCS (0.9%) and DES (1.0%) patients.In conclusion, the CCS were used in clinically higher risk patients, while DES were used in more severely diseased coronary arteries. Drug-eluting stent use resulted in lower rates of clinically driven repeat revascularization with similar rates of death, MI, stroke, and stent thrombosis. (Int Heart J 2010; 51: 231-237) Key words: Stents, Cobalt chromium, Drug-eluting, Restenosis T he rates of restenosis and major adverse cardiac events (MACE) have both been demonstrated to be significantly reduced with the use of drug-eluting stents (DES) compared with bare-metal stents (BMS) in a broad variety of studies and trials.1-6) The same trials could not demonstrate any differences in mortality or acute myocardial infarction (AMI) rates. Therefore, the reported clinical benefit of DES is entirely due to the highly significant reduction in the need for repeated interventions. However, concerns about late events associated with DES have come to light, suggesting that the indiscriminate use of DES is actually not advisable. [7][8][9] Moreover, there is controversy regarding the advantage of using DES over BMS in terms of clinical outcome for short lesions and relatively large vessels (≥ 3.0 mm). 6) Also, exploring how physicians decide which stent category to use for different uncontrolled clinical and angiographic varieties, and how this impacts clinical outcome in real practice represents is important. And finally, in the majority of the randomized DES trials, the BMS used were not the most up-to-date in terms of stent design and technology. A study involving last-generation BMS, essentially cobalt chromium stents (CCS), showed lower revascularization rates. This famous randomized trial showed that the use of DES compared to CCS in all patients has no clinical benefit, including no significant difference in restenosis related target vessel revascularization. 10) However, data regarding such comparisons and the usage patterns in clinical settings are limited in the literature. . Subjects...

show abstract

“…Quando avaliados pelo perfil de risco "TIMI risk", ocorreu progressivo aumento dos pacientes com angina instável de médio e alto riscos. Essa piora do perfil clínico dos pacientes pode ter justificado o aumento na utilização de SF, uma vez que no grupo de alta complexidade o uso de stents eluidores de agentes mostrou redução nos índices de reestenose clínica e angiográfica [21][22][23] .…”

unclassified

Errata

2008

Arq. Bras. Cardiol.

View full text Add to dashboard Cite

show abstract

Clinical Outcomes for Sirolimus-Eluting Stents and Polymer-Coated Paclitaxel-Eluting Stents in Daily Practice

Abstract: In this large real-world population, SES improved 1-year clinical results as compared to PES.

Cited by 41 publications

References 31 publications

Selective versus Exclusive Use of Drug-Eluting Stents in Treating Multivessel Coronary Artery Disease: A Real-World Cohort Study

Selective versus Exclusive Use of Drug-Eluting Stents in Treating Multivessel Coronary Artery Disease: A Real-World Cohort Study

Cobalt Chromium Coronary Stents and Drug-Eluting Stents in Real Practice

Errata

Contact Info

Product

Resources

About