Drug-eluting versus bare-metal stents in large coronary arteries

Christoph Kaiser, Soeren Galatius, Paul Erne, Franz Eberli, Hannes Alber, Hans Rickli, Giovanni Pedrazzini, Burkhard Hornig, Osmund Bertel, Piero Bonetti, Stefano De Servi, Hans Peter Brunner-La Rocca, Ingrid Ricard, Matthias Pfisterer

Research output: Contribution to journalArticle

197 Citations (Scopus)

Abstract

Background: Recent data have suggested that patients with coronary disease in large arteries are at increased risk for late cardiac events after percutaneous intervention with first-generation drug-eluting stents, as compared with bare-metal stents. We sought to confirm this observation and to assess whether this increase in risk was also seen with second-generation drug-eluting stents. Methods: We randomly assigned 2314 patients needing stents that were 3.0 mm or more in diameter to receive sirolimus-eluting, everolimus-eluting, or bare-metal stents. The primary end point was the composite of death from cardiac causes or nonfatal myocardial infarction at 2 years. Late events (occurring during months 7 to 24) and targetvessel revascularization were the main secondary end points. Results: The rates of the primary end point were 2.6% among patients receiving sirolimus-eluting stents, 3.2% among those receiving everolimus-eluting stents, and 4.8% among those receiving bare-metal stents, with no significant differences between patients receiving either drug-eluting stent and those receiving bare-metal stents. There were also no significant between-group differences in the rate of late events or in the rate of death, myocardial infarction, or stent thrombosis. Rates of target-vessel revascularization for reasons unrelated to myocardial infarction were 3.7% among patients receiving sirolimus-eluting stents, 3.1% among those receiving everolimus-eluting stents, and 8.9% among those receiving bare-metal stents. The rate of target-vessel revascularization was significantly reduced among patients receiving either drug-eluting stent, as compared with a bare-metal stent, with no significant difference between the two types of drug-eluting stents. Conclusions: In patients requiring stenting of large coronary arteries, no significant differences were found among sirolimus-eluting, everolimus-eluting, and bare-metal stents with respect to the rate of death or myocardial infarction. With the two drug-eluting stents, similar reductions in rates of target-vessel revascularization were seen. (Funded by the Basel Cardiovascular Research Foundation and the Swiss National Foundation for Research; Current Controlled Trials number, ISRCTN72444640.)

Original languageEnglish
Pages (from-to)2310-2319
Number of pages10
JournalNew England Journal of Medicine
Volume363
Issue number24
DOIs
Publication statusPublished - Dec 9 2010

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Stents
Coronary Vessels
Metals
Drug-Eluting Stents
Pharmaceutical Preparations
Sirolimus
Myocardial Infarction
Mortality
Research
Coronary Disease
Cause of Death
Thrombosis
Arteries

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Kaiser, C., Galatius, S., Erne, P., Eberli, F., Alber, H., Rickli, H., ... Pfisterer, M. (2010). Drug-eluting versus bare-metal stents in large coronary arteries. New England Journal of Medicine, 363(24), 2310-2319. https://doi.org/10.1056/NEJMoa1009406

Drug-eluting versus bare-metal stents in large coronary arteries. / Kaiser, Christoph; Galatius, Soeren; Erne, Paul; Eberli, Franz; Alber, Hannes; Rickli, Hans; Pedrazzini, Giovanni; Hornig, Burkhard; Bertel, Osmund; Bonetti, Piero; De Servi, Stefano; Brunner-La Rocca, Hans Peter; Ricard, Ingrid; Pfisterer, Matthias.

In: New England Journal of Medicine, Vol. 363, No. 24, 09.12.2010, p. 2310-2319.

Research output: Contribution to journalArticle

Kaiser, C, Galatius, S, Erne, P, Eberli, F, Alber, H, Rickli, H, Pedrazzini, G, Hornig, B, Bertel, O, Bonetti, P, De Servi, S, Brunner-La Rocca, HP, Ricard, I & Pfisterer, M 2010, 'Drug-eluting versus bare-metal stents in large coronary arteries', New England Journal of Medicine, vol. 363, no. 24, pp. 2310-2319. https://doi.org/10.1056/NEJMoa1009406
Kaiser C, Galatius S, Erne P, Eberli F, Alber H, Rickli H et al. Drug-eluting versus bare-metal stents in large coronary arteries. New England Journal of Medicine. 2010 Dec 9;363(24):2310-2319. https://doi.org/10.1056/NEJMoa1009406
Kaiser, Christoph ; Galatius, Soeren ; Erne, Paul ; Eberli, Franz ; Alber, Hannes ; Rickli, Hans ; Pedrazzini, Giovanni ; Hornig, Burkhard ; Bertel, Osmund ; Bonetti, Piero ; De Servi, Stefano ; Brunner-La Rocca, Hans Peter ; Ricard, Ingrid ; Pfisterer, Matthias. / Drug-eluting versus bare-metal stents in large coronary arteries. In: New England Journal of Medicine. 2010 ; Vol. 363, No. 24. pp. 2310-2319.
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AU - Erne, Paul

AU - Eberli, Franz

AU - Alber, Hannes

AU - Rickli, Hans

AU - Pedrazzini, Giovanni

AU - Hornig, Burkhard

AU - Bertel, Osmund

AU - Bonetti, Piero

AU - De Servi, Stefano

AU - Brunner-La Rocca, Hans Peter

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AU - Pfisterer, Matthias

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N2 - Background: Recent data have suggested that patients with coronary disease in large arteries are at increased risk for late cardiac events after percutaneous intervention with first-generation drug-eluting stents, as compared with bare-metal stents. We sought to confirm this observation and to assess whether this increase in risk was also seen with second-generation drug-eluting stents. Methods: We randomly assigned 2314 patients needing stents that were 3.0 mm or more in diameter to receive sirolimus-eluting, everolimus-eluting, or bare-metal stents. The primary end point was the composite of death from cardiac causes or nonfatal myocardial infarction at 2 years. Late events (occurring during months 7 to 24) and targetvessel revascularization were the main secondary end points. Results: The rates of the primary end point were 2.6% among patients receiving sirolimus-eluting stents, 3.2% among those receiving everolimus-eluting stents, and 4.8% among those receiving bare-metal stents, with no significant differences between patients receiving either drug-eluting stent and those receiving bare-metal stents. There were also no significant between-group differences in the rate of late events or in the rate of death, myocardial infarction, or stent thrombosis. Rates of target-vessel revascularization for reasons unrelated to myocardial infarction were 3.7% among patients receiving sirolimus-eluting stents, 3.1% among those receiving everolimus-eluting stents, and 8.9% among those receiving bare-metal stents. The rate of target-vessel revascularization was significantly reduced among patients receiving either drug-eluting stent, as compared with a bare-metal stent, with no significant difference between the two types of drug-eluting stents. Conclusions: In patients requiring stenting of large coronary arteries, no significant differences were found among sirolimus-eluting, everolimus-eluting, and bare-metal stents with respect to the rate of death or myocardial infarction. With the two drug-eluting stents, similar reductions in rates of target-vessel revascularization were seen. (Funded by the Basel Cardiovascular Research Foundation and the Swiss National Foundation for Research; Current Controlled Trials number, ISRCTN72444640.)

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