Sirolimus- vs paclitaxel-eluting stents in de novo coronary artery lesions
JAMA
; 295(8): 895-995, 22 02 2006. ilus
Article
em En
| SES-SP, SESSP-IDPCPROD, SES-SP
| ID: biblio-1064082
Biblioteca responsável:
BR79.1
Localização: BR79.1
RESUMO
Context Compared with bare metal stents, sirolimus-eluting and paclitaxel-eluting stents have been shown to markedly improve angiographic and clinical outcomes after percutaneous coronary revascularization, but their performance in the treatment of de novo coronary lesions has not been compared in a prospective multicenter study. Objective To compare the safety and efficacy of sirolimus-eluting vs paclitaxeleluting coronary stents. Design Prospective, randomized comparative trial (the REALITY trial) conducted between August 2003 and February 2004, with angiographic follow-up at 8 months and clinical follow-up at 12 months. Setting Ninety hospitals in Europe, Latin America, and Asia. Patients A total of 1386 patients (mean age, 62.6 years; 73.1% men; 28.0% with diabetes) with angina pectoris and 1 or 2 de novo lesions (2.25-3.00 mm in diameter) in native coronary arteries. Intervention Patients were randomly assigned in a 11 ratio to receive a sirolimuseluting stent (n=701) or a paclitaxel-eluting stent (n=685). Main Outcome Measures The primary end point was in-lesion binary restenosis (presence of a more than 50% luminal-diameter stenosis) at 8 months. Secondary end points included 1-year rates of target lesion and vessel revascularization and a composite end point of cardiac death, Q-wave or nonQ-wave myocardial infarction, coronary artery bypass graft surgery, or repeat target lesion revascularization. Results In-lesion binary restenosis at 8 months occurred in 86 patients (9.6%) with sirolimus-eluting stent vs 95 (11.1%) with a paclitaxel-eluting stent (relative risk [RR], 0.84; 95% confidence interval [CI], 0.61-1.17; P=.31). For sirolimus- vs paclitaxeleluting stents, respectively, the mean (SD) in-stent late loss was 0.09 (0.43) mm vs 0.31 (0.44) mm (difference, −0.22 mm; 95% CI, −0.26 to −0.18 mm; P .001), mean (SD) in-stent diameter stenosis was 23.1% (16.6%) vs 26.7% (15.8%) (difference, −3.60%; 95% CI, −5.12% to −2.08%; P .001), and the number of major adverse cardiac events at 1 year was 73 (10.7%) vs 76 (11.4%) (RR, 0.94; 95% CI, 0.69- 1.27; P=.73). Conclusion In this trial comparing sirolimus- and paclitaxel-eluting coronary stents, there were no differences in the rates of binary restenosis or major adverse cardiac events.
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Coleções:
06-national
/
BR
Base de dados:
SES-SP
/
SESSP-IDPCPROD
Assunto principal:
Stents
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Angiografia Coronária
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Paclitaxel
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Sirolimo
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Reestenose Coronária
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Traumatismos Cardíacos
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Revascularização Miocárdica
Tipo de estudo:
Clinical_trials
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Etiology_studies
Idioma:
En
Revista:
JAMA
Ano de publicação:
2006
Tipo de documento:
Article