1. Long-term safety and efficacy of second-generation everolimus-eluting stents compared to other limus-eluting stents and bare metal stents in patients with acute coronary syndrome.
- Author
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Omar A, Torguson R, Kitabata H, Pendyala LK, Loh JP, Magalhaes MA, Satler LF, Suddath WO, Pichard AD, and Waksman R
- Subjects
- Acute Coronary Syndrome diagnosis, Aged, Antineoplastic Agents, Cause of Death trends, Coronary Restenosis epidemiology, Everolimus, Female, Follow-Up Studies, Humans, Immunosuppressive Agents pharmacology, Incidence, Male, Middle Aged, Prosthesis Design, Retrospective Studies, Risk Factors, Sirolimus pharmacology, Time Factors, Treatment Outcome, Washington epidemiology, Acute Coronary Syndrome surgery, Coronary Restenosis prevention & control, Drug-Eluting Stents, Percutaneous Coronary Intervention methods, Sirolimus analogs & derivatives
- Abstract
Objectives: This study aimed to investigate the long-term safety and efficacy of everolimus-eluting stents (EES) compared with other limus-eluting stents and bare metal stents (BMS) in ACS patients., Background: There have been concerns about the long-term safety of drug-eluting stents in the setting of acute coronary syndrome., Methods: The study cohort included 1,612 patients presenting with acute coronary syndrome who underwent BMS, SES, E-ZES, or EES implantation. End points included probable or definite stent thrombosis and major adverse cardiovascular events (MACE), defined as a composite of all-cause death, Q-wave myocardial infarction, and target lesion revascularization up to 3 years., Results: The overall MACE rates were significantly higher for both BMS and SES, but not E-ZES, when compared with EES (EES vs. BMS: HR 2.68, 95% CI 1.91-3.78, P <0.001; EES vs. SES: HR 1.75, 95% CI 1.24-2.47, P = 0.001 and EES vs., E-Zes: HR 1.08, 95% CI 0.65-1.77, P = 0.72). Stent thrombosis rates were similar for EES, E-ZES, and BMS but higher for SES throughout the 3-year follow-up (EES vs. BMS: HR 1.02, 95% CI: 0.31-3.35, P = 0.973; EES vs. SES: HR 4.90, 95% CI: 1.75-13.69, P = 0.002 and EES vs., E-Zes: HR 1.63, 95% CI 0.37-7.31, P = 0.449)., Conclusions: There was an improvement in the long-term outcome for MACE with EES when compared to earlier-generation stents, but this was comparable with the 2nd-generation E-ZES. There was no additional risk of early or late stent thrombosis in EES when compared with BMS., (© 2014 Wiley Periodicals, Inc.)
- Published
- 2014
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