Sirolimus-eluting and paclitaxel-eluting stents for coronary revascularization. Export

@article{citeulike:2504290, abstract = {BACKGROUND: Sirolimus-eluting stents and paclitaxel-eluting stents, as compared with bare-metal stents, reduce the risk of restenosis. It is unclear whether there are differences in safety and efficacy between the two types of drug-eluting stents. METHODS: We conducted a randomized, controlled, single-blind trial comparing sirolimus-eluting stents with paclitaxel-eluting stents in 1012 patients undergoing percutaneous coronary intervention. The primary end point was a composite of major adverse cardiac events (death from cardiac causes, myocardial infarction, and ischemia-driven revascularization of the target lesion) by nine months. Follow-up angiography was completed in 540 of 1012 patients (53.4 percent). RESULTS: The two groups had similar baseline clinical and angiographic characteristics. The rate of major adverse cardiac events at nine months was 6.2 percent in the sirolimus-stent group and 10.8 percent in the paclitaxel-stent group (hazard ratio, 0.56; 95 percent confidence interval, 0.36 to 0.86; P=0.009). The difference was driven by a lower rate of target-lesion revascularization in the sirolimus-stent group than in the paclitaxel-stent group (4.8 percent vs. 8.3 percent; hazard ratio, 0.56; 95 percent confidence interval, 0.34 to 0.93; P=0.03). Rates of death from cardiac causes were 0.6 percent in the sirolimus-stent group and 1.6 percent in the paclitaxel-stent group (P=0.15); the rates of myocardial infarction were 2.8 percent and 3.5 percent, respectively (P=0.49); and the rates of angiographic restenosis were 6.6 percent and 11.7 percent, respectively (P=0.02). CONCLUSIONS: As compared with paclitaxel-eluting stents, the use of sirolimus-eluting stents results in fewer major adverse cardiac events, primarily by decreasing the rates of clinical and angiographic restenosis.}, address = {Department of Cardiology, University Hospital Bern, Bern, Switzerland. stephan.windecker@insel.ch}, author = {Windecker, S. and Remondino, A. and Eberli, F. R. and J\"{u}ni, P. and R\"{a}ber, L. and Wenaweser, P. and Togni, M. and Billinger, M. and T\"{u}ller, D. and Seiler, C. and Roffi, M. and Corti, R. and S\"{u}tsch, G. and Maier, W. and L\"{u}scher, T. and Hess, O. M. and Egger, M. and Meier, B.}, citeulike-article-id = {2504290}, citeulike-linkout-0 = {http://dx.doi.org/10.1056/NEJMoa051175}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/16105989}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=16105989}, day = {18}, doi = {10.1056/NEJMoa051175}, issn = {1533-4406}, journal = {N Engl J Med}, keywords = {journal}, month = {August}, number = {7}, pages = {653--662}, posted-at = {2008-03-10 19:50:08}, priority = {2}, title = {Sirolimus-eluting and paclitaxel-eluting stents for coronary revascularization.}, url = {http://dx.doi.org/10.1056/NEJMoa051175}, volume = {353}, year = {2005} }

TY - JOUR ID - citeulike:2504290 L3 - citeulike-article-id:2504290 N2 - BACKGROUND: Sirolimus-eluting stents and paclitaxel-eluting stents, as compared with bare-metal stents, reduce the risk of restenosis. It is unclear whether there are differences in safety and efficacy between the two types of drug-eluting stents. METHODS: We conducted a randomized, controlled, single-blind trial comparing sirolimus-eluting stents with paclitaxel-eluting stents in 1012 patients undergoing percutaneous coronary intervention. The primary end point was a composite of major adverse cardiac events (death from cardiac causes, myocardial infarction, and ischemia-driven revascularization of the target lesion) by nine months. Follow-up angiography was completed in 540 of 1012 patients (53.4 percent). RESULTS: The two groups had similar baseline clinical and angiographic characteristics. The rate of major adverse cardiac events at nine months was 6.2 percent in the sirolimus-stent group and 10.8 percent in the paclitaxel-stent group (hazard ratio, 0.56; 95 percent confidence interval, 0.36 to 0.86; P=0.009). The difference was driven by a lower rate of target-lesion revascularization in the sirolimus-stent group than in the paclitaxel-stent group (4.8 percent vs. 8.3 percent; hazard ratio, 0.56; 95 percent confidence interval, 0.34 to 0.93; P=0.03). Rates of death from cardiac causes were 0.6 percent in the sirolimus-stent group and 1.6 percent in the paclitaxel-stent group (P=0.15); the rates of myocardial infarction were 2.8 percent and 3.5 percent, respectively (P=0.49); and the rates of angiographic restenosis were 6.6 percent and 11.7 percent, respectively (P=0.02). CONCLUSIONS: As compared with paclitaxel-eluting stents, the use of sirolimus-eluting stents results in fewer major adverse cardiac events, primarily by decreasing the rates of clinical and angiographic restenosis. IS - 7 JF - N Engl J Med SN - 1533-4406 AD - Department of Cardiology, University Hospital Bern, Bern, Switzerland. stephan.windecker@insel.ch EP - 662 TI - Sirolimus-eluting and paclitaxel-eluting stents for coronary revascularization. VL - 353 SP - 653 KW - journal AU - Windecker, S AU - Remondino, A AU - Eberli, FR AU - Jüni, P AU - Räber, L AU - Wenaweser, P AU - Togni, M AU - Billinger, M AU - Tüller, D AU - Seiler, C AU - Roffi, M AU - Corti, R AU - Sütsch, G AU - Maier, W AU - Lüscher, T AU - Hess, OM AU - Egger, M AU - Meier, B PY - 2005/08/18/ UR - http://dx.doi.org/10.1056/NEJMoa051175 ER -