Comparison of Sirolimus Versus Paclitaxel Eluting Stents for Treatment of Coronary In-Stent Restenosis

Flavio Airoldi, Carlo Briguori, Ioannis Iakovou, Goran Stankovic, Giuseppe Biondi-Zoccai, Mauro Carlino, Alaide Chieffo, Matteo Montorfano, John Cosgrave, Iassen Michev, Renata Rogacka, Giuseppe Massimo Sangiorgi, Antonio Colombo

Research output: Contribution to journalArticle

Abstract

In patients with in-stent restenosis (ISR) inside bare metal stents, drug-eluting stents reduce the recurrence of restenosis compared with balloon angioplasty. However, few data are available about this therapeutic modality in the case of diffuse restenosis. The aim of this study was to evaluate the immediate and mid-term outcome of sirolimus- and paclitaxel-eluting stent implantation in diffuse ISR and determine the predictors of clinical and angiographic restenosis recurrence. A series of 161 consecutive patients with 194 diffuse ISR lesions (>10 mm) treated with drug-eluting stent implantation were evaluated. Major adverse cardiac events were defined as death, myocardial infarction, and the need for target lesion revascularization. During a mean follow-up of 8.2 ± 3.4 months, the cumulative incidence of major adverse cardiac events was 19% in the SES group and 24% in the PES group (p = 0.56). Angiographic follow-up was performed in 80% of the lesions. The overall restenosis rate was 22% and was not significantly different between lesions treated with sirolimus-eluting (20%) or paclitaxel-eluting (25%, p = 0.55) stents. The incidence of restenosis was higher in diabetics (32%) than in nondiabetics (16%, odds ratio 2.5, 95% confidence interval 1.1 to 5.5, p = 0.02). By multivariate analysis, diabetes was confirmed to be the only independent predictor of recurrent restenosis (odds ratio 3.53, 95% confidence interval 1.39 to 9.02, p = 0.008). In conclusion, drug-eluting stent implantation for diffuse ISR is associated with acceptable clinical and angiographic results. The association of diffuse restenosis and diabetes mellitus is an unfavorable condition leading to a high risk of recurrence.

Original languageEnglish
Pages (from-to)1182-1187
Number of pages6
JournalThe American Journal of Cardiology
Volume97
Issue number8
DOIs
Publication statusPublished - Apr 15 2006

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Sirolimus
Paclitaxel
Stents
Drug-Eluting Stents
Recurrence
Therapeutics
Odds Ratio
Confidence Intervals
Balloon Angioplasty
Incidence
Diabetes Mellitus
Multivariate Analysis
Metals
Myocardial Infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Comparison of Sirolimus Versus Paclitaxel Eluting Stents for Treatment of Coronary In-Stent Restenosis. / Airoldi, Flavio; Briguori, Carlo; Iakovou, Ioannis; Stankovic, Goran; Biondi-Zoccai, Giuseppe; Carlino, Mauro; Chieffo, Alaide; Montorfano, Matteo; Cosgrave, John; Michev, Iassen; Rogacka, Renata; Sangiorgi, Giuseppe Massimo; Colombo, Antonio.

In: The American Journal of Cardiology, Vol. 97, No. 8, 15.04.2006, p. 1182-1187.

Research output: Contribution to journalArticle

Airoldi, F, Briguori, C, Iakovou, I, Stankovic, G, Biondi-Zoccai, G, Carlino, M, Chieffo, A, Montorfano, M, Cosgrave, J, Michev, I, Rogacka, R, Sangiorgi, GM & Colombo, A 2006, 'Comparison of Sirolimus Versus Paclitaxel Eluting Stents for Treatment of Coronary In-Stent Restenosis', The American Journal of Cardiology, vol. 97, no. 8, pp. 1182-1187. https://doi.org/10.1016/j.amjcard.2005.11.034
Airoldi, Flavio ; Briguori, Carlo ; Iakovou, Ioannis ; Stankovic, Goran ; Biondi-Zoccai, Giuseppe ; Carlino, Mauro ; Chieffo, Alaide ; Montorfano, Matteo ; Cosgrave, John ; Michev, Iassen ; Rogacka, Renata ; Sangiorgi, Giuseppe Massimo ; Colombo, Antonio. / Comparison of Sirolimus Versus Paclitaxel Eluting Stents for Treatment of Coronary In-Stent Restenosis. In: The American Journal of Cardiology. 2006 ; Vol. 97, No. 8. pp. 1182-1187.
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