Sirolimus-eluting stents at two years:: A pooled analysis of SIRIUS, E-SIRIUS, and C-SIRIUS with emphasis on late revascularizations and stent thromboses

被引:60
作者
Schampaert, Erick [1 ]
Moses, Jeffrey W.
Schofer, Joachim
Schlueter, Michael
Gershlick, Anthony H.
Cohen, Eric A.
Palisaitis, Donald A.
Breithardt, Guenter
Donohoe, Dennis J.
Wang, Hong
Popma, Jeffrey J.
Kuntz, Richard E.
Leon, Martin B.
机构
[1] Hop Sacre Coeur, Div Cardiol, Montreal, PQ H4J 1C5, Canada
[2] Sunnybrook & Womens Coll, Ctr Hlth Sci, Dept Cardiol & Angiol, Toronto, ON, Canada
[3] Columbia Univ, Med Ctr, Ctr Intervent Vasc Therapies, New York, NY USA
[4] Cordis Johnson & Johnson, Warren, NJ USA
[5] Brigham & Womens Hosp, Boston, MA 02115 USA
[6] Ctr Cardiol & Vasc Intervent, Hamburg, Germany
[7] Univ Munster Hosp, Munster, Germany
[8] Glenfield Hosp, Leicester, Leics, England
关键词
D O I
10.1016/j.amjcard.2006.01.049
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Prospective follow-up at 2 years was obtained for 98.7% of the pooled 1,510 patients enrolled in SIRIUS, E-SIRIUS and C-SIRIUS, 3 randomized controlled trials that compared sirolimus-eluting stents (SESs) with bare metal stents (BMSs) to treat long stenoses in small coronary arteries. By 720 days, clinically driven target lesion revascularizations were performed in 5.7% of patients with SESs versus 22.6% of patients with BMSS (risk ratio 0.25, 95% confidence interval 0.18 to 0.35, p < 0.001). Of these, late target lesion revascularization (from 271 to 720 days) was performed in 12 patients who received SESs (1.6%) compared with 37 patients with BMSs (4.9%) (risk ratio 0.32, 0.17 to 0.61, p < 0.001). Stent thromboses occurred in 7 of 758 patients with SESs (0.9%, 4 subacute, 3 late) and 5 of 752 patients with BMSs (0.7%, 1 subacute, 4 late) (risk ratio 1.39, 95% confidence interval 0.44 to 4.36, p = 0.774). The Kaplan-Meier estimate of freedom from major cardiac adverse events was 89.3% for patients with SESs versus 73.4% for patients with BMSs (p < 0.001). This analysis demonstrates the sustained efficacy and safety of sirolimus-eluting stents at 2 years, characterized by a persistent significant benefit in freedom from repeat revascularization compared with BMSs and a low risk of late stent thrombosis, not different from BMSs. (c) 2006 Elsevier Inc. All rights reserved.
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页码:36 / 41
页数:6
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