Clinical outcome following aleatory implantation of paclitaxel-eluting or sirolimus-eluting stents in complex coronary lesions

John Cosgrave, Pierfrancesco Agostoni, Lei Ge, Ioannis Iakovou, Alaide Chieffo, Giuseppe G L Biondi-Zoccai, Giuseppe M. Sangiorgi, Matteo Montorfano, Iassen Michev, Flavio Airoldi, Mauro Carlino, Nicola Corvaja, Ermino Bonizzoni, Antonio Colombo

Research output: Contribution to journalArticlepeer-review

Abstract

We compared the clinical efficacy of paclitaxel-eluting stents (PESs) and sirolimus-eluting stents (SESs) in a contemporary cohort of patients who had complex lesions. We collected data on 9-month outcomes in 529 patients (281 in the PES group and 248 in the SES group) whose de novo lesions were treated with drug-eluting stents. The end point was per-patient in-hospital and follow-up major adverse cardiac events, which were defined as a composite of death, myocardial infarction, and target vessel revascularization, including target lesion revascularization. There were no in-hospital deaths or repeat revascularizations; however, 5.7% of the PES group and 2% of the SES group developed a myocardial infarction (p = 0.04). At a median follow-up of 10.6 months, the rate of major adverse cardiac events was similar between groups (18.1% vs 21%, adjusted hazard ratio 0.85, 95% confidence interval 0.57 to 1.25), without any difference in the occurrence of death or myocardial infarction. Diabetes and total stent length were independent predictors of major adverse cardiac events. Propensity analysis confirmed the similarity between devices (hazard ratio 0.87, 95% confidence interval 0.62 to 1.25). Most restenoses were focal and only 2 patients required surgical revascularization. In conclusion, implantation of drug-eluting stents in complex lesions was associated with favorable results and most patients remained free from surgical revascularization at follow-up. Overall, the 2 available stent platforms had similar performance characteristics.

Original languageEnglish
Pages (from-to)1663-1668
Number of pages6
JournalThe American Journal of Cardiology
Volume96
Issue number12
DOIs
Publication statusPublished - Dec 15 2005

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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