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Long-Term Comparison of Everolimus-Eluting and Sirolimus-Eluting Stents for Coronary Revascularization
- Source :
- Journal of the American College of Cardiology. 57(21):2143-2151
- Publication Year :
- 2011
- Publisher :
- Elsevier BV, 2011.
-
Abstract
- Objectives This study sought to compare the unrestricted use of everolimus-eluting stents (EES) with sirolimus-eluting stents (SES) in patients undergoing percutaneous coronary intervention. Background It is unclear whether there are differences in safety and efficacy between EES and SES during long-term follow-up. Methods Using propensity score matching, clinical outcome was compared among 1,342 propensity score–matched pairs of patients treated with EES and SES. The primary outcome was a composite of death, MI, and target vessel revascularization. Results The median follow-up was 1.5 years with a maximum of 3 years. The primary outcome occurred in 14.9% of EES- and 18.0% of SES-treated patients up to 3 years (hazard ratio [HR]: 0.83, 95% confidence interval [CI]: 0.68 to 1.00, p = 0.056). All-cause mortality (6.0% vs. 6.5%, HR: 0.92, 95% CI: 0.68 to 1.25, p = 0.59) was similar, risks of myocardial infarction (MI) (3.3% vs. 5.0%, HR: 0.62, 95% CI: 0.42 to 0.92, p = 0.017), and target vessel revascularization (7.0% vs. 9.6%, HR: 0.75, 95% CI: 0.57 to 0.99, p = 0.039) were lower with EES than SES. Definite stent thrombosis (ST) (HR: 0.30, 95% CI: 0.12 to 0.75, p = 0.01) was less frequent among patients treated with EES. The reduced rate of MI with EES was explained in part by the lower risk of definite ST and the corresponding decrease in events associated with ST (HR: 0.25, 95% CI: 0.08 to 0.75, p = 0.013). Conclusions The unrestricted use of EES appears to be associated with improved clinical long-term outcome compared with SES. Differences in favor of EES are driven in part by a lower risk of MI associated with ST.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Myocardial Infarction
Coronary Artery Disease
030204 cardiovascular system & hematology
coronary disease
Lower risk
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Everolimus
030212 general & internal medicine
Myocardial infarction
Angioplasty, Balloon, Coronary
Propensity Score
Aged
Antibacterial agent
Sirolimus
stent thrombosis
business.industry
Hazard ratio
drug-eluting stents
Percutaneous coronary intervention
Middle Aged
medicine.disease
Confidence interval
3. Good health
Treatment Outcome
Drug-eluting stent
Cardiology
Female
business
Cardiology and Cardiovascular Medicine
Immunosuppressive Agents
Follow-Up Studies
medicine.drug
Subjects
Details
- ISSN :
- 07351097
- Volume :
- 57
- Issue :
- 21
- Database :
- OpenAIRE
- Journal :
- Journal of the American College of Cardiology
- Accession number :
- edsair.doi.dedup.....e1446a6a8f443a2b70fa1a10ce0bc281
- Full Text :
- https://doi.org/10.1016/j.jacc.2011.01.023