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Effectiveness of Drug-Eluting Stents in Real-World Patients
Debabrata Mukherjee, MD;
David J. Moliterno, MD
JAMA. 2008;299(4):454-455.
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Drug-eluting stents are a major advance in percutaneous coronary intervention (PCI) because they reduce the need for repeat target lesion revascularization several-fold compared with bare-metal stents. Early randomized clinical trials separately testing sirolimus-eluting stents1-2 and paclitaxel-eluting stents3-4 against their bare-metal counterparts demonstrated that rates of target lesion revascularization were reduced from approximately 10% to 15% to approximately 4% to 5%, whereas the rates of death, myocardial infarction, and stent thrombosis were similar between bare-metal and drug-eluting stents. Because these studies were performed for device regulatory approval, they enrolled patients and lesions with relatively low risk for restenosis and adverse events. Subsequent head-to-head trials of sirolimus- and paclitaxel-eluting stents in cohorts with a broader risk profile have provided inconsistent results; some trials have suggested equivalent rates of target lesion revascularization for these stents,5-6 whereas others have reported superiority of sirolimus-eluting stents.7-9
Initial clinical trials . . . [Full Text of this Article]
Author Affiliations: Gill Heart Institute and Division of Cardiovascular Medicine, University of Kentucky, Lexington.
RELATED ARTICLE
Comparison of Paclitaxel- and Sirolimus-Eluting Stents in Everyday Clinical Practice: The SORT OUT II Randomized Trial
Anders M. Galløe, Leif Thuesen, Henning Kelbæk, Per Thayssen, Klaus Rasmussen, Peter R. Hansen, Niels Bligaard, Kari Saunamäki, Anders Junker, Jens Aarøe, Ulrik Abildgaard, Jan Ravkilde, Thomas Engstrøm, Jan S. Jensen, Henning R. Andersen, Hans E. Bøtker, Søren Galatius, Steen D. Kristensen, Jan K. Madsen, Lars R. Krusell, Steen Z. Abildstrøm, Ghita B. Stephansen, Jens F. Lassen, and for the SORT OUT II Investigators
JAMA. 2008;299(4):409-416.
ABSTRACT
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
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Are Sirolimus-Eluting and Paclitaxel-Eluting Stents Equivalent?
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