TY - JOUR
T1 - Safety and efficacy of overlapping sirolimus-eluting versus paclitaxel-eluting stents
AU - Shishehbor, Mehdi H.
AU - Amini, Reza
AU - Raymond, Russell E.
AU - Bavry, Anthony A.
AU - Brener, Sorin J.
AU - Kapadia, Samir R.
AU - Whitlow, Patrick L.
AU - Ellis, Stephen G.
AU - Bhatt, Deepak L.
N1 - Funding Information:
MHS, RA, AAB, SJB, SRK have no conflict of interest to report. RER serves on the Boston Scientific speaker's bureau. DLB discloses the following relationships: research grants (directly to the institution)—Bristol Myers Squibb, Eisai, Ethicon, Heartscape, Sanofi Aventis, and The Medicines Company; honoraria (donated to nonprofits for >2 years)—Astra Zeneca, Bristol Myers Squibb, Centocor, Daiichi-Sankyo, Eisai, Eli Lilly, GlaxoSmithKline, Millennium, Paringenix, PDL, Sanofi Aventis, Schering Plough, The Medicines Company, and tns Healthcare; speaker's bureau (>2 years ago)—Bristol Myers Squibb, Sanofi Aventis, and The Medicines Company; consultant/advisory board (donated to nonprofits for >2 years)—Astellas, Astra Zeneca, Bristol Myers Squibb, Cardax, Centocor, Cogentus, Daiichi-Sankyo, Eisai, Eli Lilly, GlaxoSmithKline, Johnson&Johnson, McNeil, Medtronic, Millennium, Molecular Insights, Otsuka, Paringenix, PDL, Philips, Portola, Sanofi Aventis, Schering Plough, Scios, Takeda, The Medicines Company, tns Healthcare, and Vertex; expert testimony regarding clopidogrel (>2 years ago; the compensation was donated to a nonprofit organization); Cleveland Clinic Coordinating Center currently receives or has received research funding from Abraxis, Alexion Pharma, AstraZeneca, Atherogenics, Aventis, Biosense Webster, Biosite, Boehringer Ingelheim, Boston Scientific, Bristol-Myers Squibb, Cardionet, Centocor, Converge Medical Inc, Cordis, Dr Reddy's, Edwards Lifesciences, Esperion, GE Medical, Genentech, Gilford, GSK, Guidant, J&J, Kensey-Nash, Lilly, Medtronic, Merck, Mytogen, Novartis, Novo Nordisk, Orphan Therapeutics, P&G Pharma, Pfizer, Roche, Sankyo, Sanofi-Aventis, Schering Plough, Scios, St Jude Medical, Takeda, TMC, VasoGenix, and Viacor. SGE serves on the advisory board of Cordis and Boston Scientific Inc. PLW serves as a consultant and/or on the advisory board of ICON Interventional Systems and Medlogics.
Funding Information:
This is supported in part by the National Institutes of Health, National Institute of Child Health and Human Development, Multidisciplinary Clinical Research Career Development Programs grant K12 HD049091 and the National Institutes of Health Loan Repayment Program (Dr Shishehbor).
PY - 2008/6
Y1 - 2008/6
N2 - Background: The short-term and long-term safety and efficacy of paclitaxel versus sirolimus-overlapping drug-eluting stents (DES) is unknown. We sought to examine the clinical consequences of overlapping sirolimus versus paclitaxel DES. Methods: We reviewed catheterization reports from April 2003 to May 2005 for all patients who underwent percutaneous coronary revascularization with DES. All patients were followed-up for at least 1 year. Patients were included if they received only 2 single-type overlapping stent (eg, sirolimus-sirolimus) during the index procedure. The end points included early (inhospital and 30-day) and late composite of all-cause mortality, stent thrombosis, myocardial infarction, and target lesion revascularization. Results: A total of 282 individuals met our study criteria. Of these, 188 had sirolimus and 94 had paclitaxel-overlapping DES. There were 78 events for a median follow-up of 24 months for the composite end point. No statistically significant differences between overlapping sirolimus and paclitaxel DES were seen for inhospital, 30-day (16% vs 23%, respectively; P = .13), and long-term (25% vs 33%, respectively; P = .16) composite end points. In addition, in Kaplan-Meier and Cox proportional hazard analysis, no significant differences for the composite end point were noted. Conclusions: In this analysis, there were no significant differences in safety or efficacy between the 2 types of overlapping DES. Trends toward more events with overlapping paclitaxel stents should be evaluated in an adequately powered randomized controlled trial.
AB - Background: The short-term and long-term safety and efficacy of paclitaxel versus sirolimus-overlapping drug-eluting stents (DES) is unknown. We sought to examine the clinical consequences of overlapping sirolimus versus paclitaxel DES. Methods: We reviewed catheterization reports from April 2003 to May 2005 for all patients who underwent percutaneous coronary revascularization with DES. All patients were followed-up for at least 1 year. Patients were included if they received only 2 single-type overlapping stent (eg, sirolimus-sirolimus) during the index procedure. The end points included early (inhospital and 30-day) and late composite of all-cause mortality, stent thrombosis, myocardial infarction, and target lesion revascularization. Results: A total of 282 individuals met our study criteria. Of these, 188 had sirolimus and 94 had paclitaxel-overlapping DES. There were 78 events for a median follow-up of 24 months for the composite end point. No statistically significant differences between overlapping sirolimus and paclitaxel DES were seen for inhospital, 30-day (16% vs 23%, respectively; P = .13), and long-term (25% vs 33%, respectively; P = .16) composite end points. In addition, in Kaplan-Meier and Cox proportional hazard analysis, no significant differences for the composite end point were noted. Conclusions: In this analysis, there were no significant differences in safety or efficacy between the 2 types of overlapping DES. Trends toward more events with overlapping paclitaxel stents should be evaluated in an adequately powered randomized controlled trial.
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U2 - 10.1016/j.ahj.2008.01.017
DO - 10.1016/j.ahj.2008.01.017
M3 - Article
C2 - 18513522
AN - SCOPUS:44149106648
SN - 0002-8703
VL - 155
SP - 1075
EP - 1080
JO - American heart journal
JF - American heart journal
IS - 6
ER -