Safety and Efficacy of Sirolimus¬and Paclitaxel- Eluting Coronary Stents  

Oleh:

Stone, Gregg W. ; Moses, Jeffrey W. ; Ellis, Stephen G ; Schofer, JoacFer ; Dawkins, Keith D ; Morice, Marie-Claude ; Colombo, Antonio ; Schampaert, Erick ; Grube, Eberhard ; Kirtane, Ajay J ; Cutlip, Donald E ; Fahy, Martin ; Pocock, Stuart J. ; Mehran, Roxana ; Leon, Martin B.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 356 no. 10 (Mar. 2007), page 998.

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2007.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

BACKGROUND The safety of drug-eluting stents has been called into question by recent reports of - increased stent thrombosis, myocardial infarction, and death. Such studies have been , inconclusive because of their insufficient size, the use of historical controls, a limited - duration of follow-up, and a lack of access to original source data. METHODS We performed a pooled analysis of data from four double-blind trials in which 1748 , patients were randomly assigned to receive either sirolimus-eluting stents or bare metal stents and five double-blind trials in which 3513 patients were randomly as. signed to receive either paclitaxel-eluting stents or bare-metal stents; we then anallyzed the major clinical end points of the trials. RESULTS The 4-year rates of stent thrombosis were 1.2% in the sirolimus-stent group versus 0.6% in the bare-metal-stent group (P=0.20) and 1.3% in the paclitaxel-stent group versus 0.9% in the bare-metal-stent group (P=0.30). However, after 1 year, there were five episodes of stent thrombosis in patients with sirolimus-eluting stents versus none in patients with bare-metal stents (P=0.025) and nine episodes in patients with paclitaxel-eluting stents versus two in patients with bare-metal stents (P = 0.028). The 4-year rates of target-lesion revascularization were markedly reduced in both the sirolimus-stent group and the paclitaxel-stent group, as compared with the bare-metal-stent groups. The rates of death or myocardial infarction did not differ significantly between the groups with drug-eluting stents and those with bare-metal stents. CONCLUSIONS Stent thrombosis after 1 year was more common with both sirolimus-eluting stents and pacIitaxel-eIuting stents than with bare-metal stents. Both drug-eluting stents were associated with a marked reduction in target-lesion revascularization. There were no significant differences in the cumulative rates of death or myocardial infarction at 4 years.

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