Safety and efficacy of overlapping sirolimus-eluting versus paclitaxel-eluting stents

Mehdi H. Shishehbor, Reza Amini, Russell E. Raymond, Anthony A. Bavry, Sorin J. Brener, Samir R. Kapadia, Patrick L. Whitlow, Stephen G. Ellis, Deepak L. Bhatt

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1075-1080
Number of pages6
JournalAmerican heart journal
Volume155
Issue number6
DOIs
StatePublished - Jun 1 2008
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Shishehbor, M. H., Amini, R., Raymond, R. E., Bavry, A. A., Brener, S. J., Kapadia, S. R., Whitlow, P. L., Ellis, S. G., & Bhatt, D. L. (2008). Safety and efficacy of overlapping sirolimus-eluting versus paclitaxel-eluting stents. American heart journal, 155(6), 1075-1080. https://doi.org/10.1016/j.ahj.2008.01.017