Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
8
pubmed:dateCreated
2006-4-17
pubmed:abstractText
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.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Apr
pubmed:issn
0002-9149
pubmed:author
pubmed:issnType
Print
pubmed:day
15
pubmed:volume
97
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1182-7
pubmed:dateRevised
2007-11-15
pubmed:meshHeading
pubmed-meshheading:16616023-Coronary Angiography, pubmed-meshheading:16616023-Coronary Restenosis, pubmed-meshheading:16616023-Databases as Topic, pubmed-meshheading:16616023-Diabetes Mellitus, pubmed-meshheading:16616023-Drug Delivery Systems, pubmed-meshheading:16616023-Female, pubmed-meshheading:16616023-Follow-Up Studies, pubmed-meshheading:16616023-Humans, pubmed-meshheading:16616023-Immunosuppressive Agents, pubmed-meshheading:16616023-Male, pubmed-meshheading:16616023-Middle Aged, pubmed-meshheading:16616023-Multivariate Analysis, pubmed-meshheading:16616023-Outcome Assessment (Health Care), pubmed-meshheading:16616023-Paclitaxel, pubmed-meshheading:16616023-Recurrence, pubmed-meshheading:16616023-Risk Factors, pubmed-meshheading:16616023-Sirolimus, pubmed-meshheading:16616023-Stents
pubmed:year
2006
pubmed:articleTitle
Comparison of sirolimus versus paclitaxel eluting stents for treatment of coronary in-stent restenosis.
pubmed:affiliation
San Raffaele Hospital IRCCS, Milan, Italy.
pubmed:publicationType
Journal Article, Comparative Study