Paclitaxel-Eluting or Sirolimus-Eluting Stents to Prevent Restenosis in Diabetic Patients

Dibra, Alban; Kastrati, Adnan; Mehilli, Julinda; Pache, Jürgen; Schühlen, Helmut; Beckerath, Nicolas von; Ulm, Kurt; Wessely, Rainer; Dirschinger, Josef; Schömig, Albert

doi:10.1056/nejmoa044372

Cited by 449 publications

(205 citation statements)

References 36 publications

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“…82,[107][108][109][110][111][112][113][114][115][116][117] Of these eight RCTs, only one (TAXi) was identified in our initial electronic search of bibliographic databases, five (SIRTAX, REALITY, ISAR-DIABETES, CORPAL, BASKET 82,107,108,[110][111][112][113][114][115][116][117] ) through handsearching activities and two (DOMINO and ISAR-TEST 118,119 ) from manufacturer submissions to NICE.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

Drug-eluting stents: a systematic review and economic evaluation

Hill¹,

Boland²,

Dickson³

et al. 2007

Health Technol Assess

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Section: Description Of Included Studiesmentioning

confidence: 99%

Drug-eluting stents: a systematic review and economic evaluation

Hill¹,

Boland²,

Dickson³

et al. 2007

Health Technol Assess

View full text Add to dashboard Cite

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“…In contrast to the REALITY trial, the SIRTAX study found that the Taxus stent was associated with a higher major adverse cardiac event rate and a higher target lesion revascularization rate. Likewise, the ISAR-DIABETES randomized trial 24) that compared Cypher and Taxus stents in 250 diabetic patients with de novo lesions found the restenosis rate associated with the Cypher stent was lower than that associated with the Taxus stent(6.9% vs. 16.5%, respectively, p= 0.03). That study also showed that the two stents did not differ in terms of the target lesion revascularization rates(6.4% vs. 12.2%, respectively, p=0.13).…”

Section: Stent-related Factorsmentioning

confidence: 99%

Predictive Factors for Restenosis after Drug-Eluting Stent Implantation

Lee

Park

2007

Korean Circ J

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Background and Objectives：Despite the dramatic reduction in restenosis conferred by drug-eluting stents (DES), restenosis remains a significant problem for real-world patients. Restenosis is a complex phenomenon, and a variety of stent-, drug-, patient-and lesion-related factors have been studied as the determinants of restenosis after DES implantation. Methods and Results：The stent delivery system, the polymer and the drug are integral components of DES, and these are the device-specific factors that can affect restenosis. While the sirolimuseluting Cypher stent appears to provide better outcomes than the paclitaxel-eluting Taxus stent in high-risk patient groups with complex lesions, such differences between the two DES are not apparent in the low-risk groups. Diabetic patients are generally prone to restenosis after percutaneous coronary intervention, but there are conflicting findings regarding the impact of diabetes mellitus on restenosis after DES implantation. The postintervention final lumen area continues to be the most important determinant of restenosis after DES implantation, indicating that a greater stented area contributes to a decreased rate of restenosis even in the DES era. Nonuniform strut distribution and stent fracture also contribute to the development of restenosis after DES implantation. In addition, the risk of restenosis increases linearly according to lesion length, and a "full metal jacket" approach in small vessels is related to a high risk of DES failure. Conclusion：Small vessel disease, diffuse disease and the type of DES are important predictors of restenosis after DES implantation. However, predicting restenosis remains difficult, and this indicates the need for further studies in order to ultimately identify those patients who are at high risk for DES failure.

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“…Many previous randomized studies have compared paclitaxel-and sirolimus-eluting stents [15][16][17][18][19][20][21][22][23][24][25] . However, in addition to the drug, the stents used in those studies differed in all other characteristics (coating and platform), which consequently prevented a more conclusive evaluation of the effects of the drugs themselves.…”

Section: Discussionmentioning

confidence: 99%