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Cardiovasc Revasc Med. 2012 Nov-Dec;13(6):307-10. doi: 10.1016/j.carrev.2012.09.003.

Everolimus-eluting stents compared with paclitaxel-eluting stents for treatment of coronary in-stent restenoses.

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1
Department of Internal Medicine II, University of Ulm, Albert-Einstein-Allee 23, Ulm, Germany.

Abstract

BACKGROUND:

Everolimus-eluting stent (EES) implantation was superior to paclitaxel-eluting stent (PES) implantation for treatment of de-novo coronary artery disease. We evaluated the outcome of EES compared with PES for treatment of restenosis in bare-metal and drug-eluting stents (DES).

METHODS AND MATERIALS:

In a prospective observational study patients with in-stent restenosis (ISR) were treated with EES (N=91) or PES (N=107). Dual antiplatelet therapy was given for 6 months. Patients were scheduled for 6 months angiographic follow-up and 24 months clinical follow-up. Primary outcome measure was the occurrence of major adverse cardiac events (MACE) defined as a composite of cardiac death, any myocardial infarction and target lesion revascularization (TLR).

RESULTS:

Baseline data showed some differences between groups including frequency of DES restenosis, length of stented segment and reference vessel diameter. For EES versus PES occurrence of MACE (18.7% vs. 15.0%, p=0.48) and need for TLR did not differ (13.2% vs. 9.3%, p=0.39). In-stent late loss was similar with 0.20±0.39 mm for EES and 0.18±0.31mm for PES (p=0.34). Binary angiographic restenosis rate for the total segment was 18.0% and 16.7% (p=0.85), respectively. In multivariable analysis the stented length (p=0.014), minimal lumen diameter post stenting (p<0.01) and repeated restenosis (p<0.001) were risk factors for a higher late loss but not type of DES or presence of diabetes mellitus.

CONCLUSIONS:

In this observational registry treatment of DES and BMS restenosis with EES versus PES implantation resulted in similar clinical and angiographic outcome.

PMID:
23164475
DOI:
10.1016/j.carrev.2012.09.003
[Indexed for MEDLINE]
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