2-Year Clinical Outcomes After Implantation of Sirolimus-Eluting, Paclitaxel-Eluting, and Bare-Metal Coronary Stents Results From the WDHR (Western Denmark Heart Registry)

被引:52
作者
Kaltoft, Anne [1 ]
Jensen, Lisette Okkels [2 ]
Maeng, Michael [1 ]
Tilsted, Hans Henrik [3 ]
Thayssen, Per [2 ]
Bottcher, Morten [1 ]
Lassen, Jens Flensted [1 ]
Krusell, Lars Romer [1 ]
Rasmussen, Klaus [3 ,4 ]
Hansen, Knud Norregaard [1 ]
Pedersen, Lars [5 ]
Johnsen, Soren Paaske [4 ,5 ]
Sorensen, Henrik Toft [5 ,6 ]
Thuesen, Leif [1 ]
机构
[1] Aarhus Univ Hosp, Dept Cardiol, Aarhus 8200 N, Denmark
[2] Odense Univ Hosp, Dept Cardiol, DK-5000 Odense, Denmark
[3] Aarhus Univ Hosp, Dept Cardiol, Aalborg, Denmark
[4] Aarhus Univ Hosp, Cardiovasc Res Ctr, Aalborg Hosp, Aalborg, Denmark
[5] Aarhus Univ Hosp, Dept Clin Epidemiol, DK-8000 Aarhus, Denmark
[6] Boston Univ, Dept Epidemiol, Boston, MA 02215 USA
关键词
RANDOMIZED CONTROLLED-TRIAL; ARTERY-DISEASE; POOLED ANALYSIS; THROMBOSIS; SAFETY; METAANALYSIS; EFFICACY;
D O I
10.1016/j.jacc.2008.09.058
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives This registry study assessed the safety and efficacy of the 2 types of drug-eluting stents (DES), sirolimus-eluting stents (SES) and paclitaxel-eluting stents ( PES), compared with bare-metal stents (BMS). Background Drug-eluting stents may increase the risk of stent thrombosis (ST), myocardial infarction (MI), and death. Methods A total of 12,395 consecutive patients with coronary intervention and stent implantation recorded in the Western Denmark Heart Registry from January 2002 through June 2005 were followed up for 2 years. Data on death and MI were ascertained from national medical databases. We used Cox regression analysis to control for confounding. Results The 2-year incidence of definite ST was 0.64% in BMS patients, 0.79% in DES patients (adjusted relative risk [RR]: 1.09; 95% confidence interval [CI]: 0.72 to 1.65), 0.50% in SES patients (adjusted RR: 0.63, 95% CI: 0.35 to 1.15), and 1.30% in PES patients (adjusted RR: 1.82, 95% CI: 1.13 to 2.94). The incidence of MI was 3.8% in BMS-treated patients, 4.5% in DES-treated patients (adjusted RR: 1.24, 95% CI: 1.02 to 1.51), 4.1% in SES-treated patients (adjusted RR: 1.15, 95% CI: 0.91 to 1.47), and 5.3% in PES-treated patients (adjusted RR: 1.38, 95% CI: 1.06 to 1.81). Whereas overall 2-year adjusted mortality was similar in the BMS and the 2 DES stent groups, 12- to 24-month mortality was higher in patients treated with PES (RR 1.46, 95% CI: 1.02 to 2.09). Target lesion revascularization was reduced in both DES groups. Conclusions During 2 years of follow-up, patients treated with PES had an increased risk of ST and MI compared with those treated with BMS and SES. Mortality after 12 months was also increased in PES patients. (J Am Coll Cardiol 2009; 53: 658-64) (C) 2009 by the American College of Cardiology Foundation
引用
收藏
页码:658 / 664
页数:7
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