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J Am Coll Cardiol. 2006 Jan 17;47(2):449-55. Epub 2005 Dec 9.

The Stenting Coronary Arteries in Non-stress/benestent Disease (SCANDSTENT) trial.

Author information

1
Cardiac Catheterization Laboratory, Rigshospitalet, Copenhagen, Denmark. henning.kelbaek@rh.hosp.dk

Abstract

OBJECTIVES:

The purpose of the SCANDSTENT study was to evaluate the use of sirolimus-eluting stents (SES) in complex coronary lesions.

BACKGROUND:

The use of SES improves angiographic and clinical outcomes compared with bare-metal stents (BMS) in simple coronary artery lesions, but there is limited evidence of their safety and efficacy when implanted in complex lesions.

METHODS:

We randomly assigned 322 patients with symptomatic complex coronary artery disease to receive either SES or BMS. The lesions were occluded (36%), bifurcational (34%), ostial (22%), or angulated (8%) in morphology. The primary end point was the difference in minimal lumen diameter six months after stent implantation.

RESULTS:

The patients were well matched in terms of demographic and angiographic baseline characteristics; 18% had diabetes. The reference vessel diameter was 2.86 mm in mean, and the lesion length 18.0 mm. At follow-up, patients who received SES had a minimal lumen diameter of 2.48 mm compared with 1.65 mm in those who received BMS (p < 0.001), a diameter stenosis of 19.3% versus 43.8% (p < 0.001), and 2.0% versus 31.9% developed restenosis (p < 0.001). The rate of major adverse cardiac events was 4.3% with SES versus 29.3% with BMS (p < 0.001), and stent thrombosis was observed in 0.6% in the SES group versus 3.1% in the BMS group (p = 0.15).

CONCLUSIONS:

The use of SES markedly reduced restenosis and the occurrence of major adverse cardiac events in patients with complex coronary artery lesions without increasing the risk of stent thrombosis.

PMID:
16412876
DOI:
10.1016/j.jacc.2005.10.045
[Indexed for MEDLINE]
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