TY - JOUR
T1 - Long-term outcome in patients treated with sirolimus-eluting stents in complex coronary artery lesions
T2 - 3-year results of the SCANDSTENT (Stenting Coronary Arteries in Non-Stress/Benestent Disease) trial
AU - Kelbaek, Henning
AU - Kløvgaard, Lene
AU - Helqvist, Steffen
AU - Lassen, Jens F
AU - Krusell, Lars R
AU - Engstrøm, Thomas
AU - Bøtker, Hans E
AU - Jørgensen, Erik
AU - Saunamäki, Kari
AU - Aljabbari, Samir
AU - Thayssen, Per
AU - Galløe, Anders
AU - Jensen, Gunnar V H
AU - Thuesen, Leif
PY - 2008/5/27
Y1 - 2008/5/27
N2 - OBJECTIVES: Our purpose was to evaluate the long-term use of sirolimus-eluting stents (SES) and bare-metal stents (BMS) in patients with complex coronary artery lesions.BACKGROUND: Although the use of SES has proved to be effective in patients with simple coronary artery lesions, there are limited data of the long-term outcome of patients with complex coronary artery lesions.METHODS: We randomly assigned 322 patients with total coronary occlusions or lesions located in bifurcations, ostial, or angulated segments of the coronary arteries to have SES or BMS implanted.RESULTS: At 3 years, major adverse cardiac events had occurred in 20 patients (12%) in the SES group and in 59 patients (38%) in the BMS group (p < 0.001). Four versus 2 patients suffered a cardiac death (p = NS), and 5 versus 1 died of a noncardiac disease (p = NS) in the SES versus the BMS group. Six patients in the SES group versus 15 patients in the BMS group suffered a myocardial infarction (p < 0.05) during the 3-year observation period, and target lesion revascularization was performed in 8 patients (4.9%) versus 53 patients (33.8%), respectively (p < 0.001); of these, 4 in the SES versus 7 in the BMS group were performed between 1 and 3 years after the index treatment (p = NS). According to revised definitions, stent thrombosis occurred in 5 patients (3.1%) in the SES group and in 7 patients (4.4%) in the BMS group (p = NS); very late stent thrombosis was observed in 4 versus 1 patient.CONCLUSIONS: A continued benefit was observed up to 3 years after implantation of SES in patients with complex coronary artery lesions. The rate of late adverse events was similar in the 2 groups, and stent thromboses occurred rarely after 1 year. (Sirolimus Eluting Stents in Complex Coronary Lesions [SCANDSTENT]; NCT00151658)
AB - OBJECTIVES: Our purpose was to evaluate the long-term use of sirolimus-eluting stents (SES) and bare-metal stents (BMS) in patients with complex coronary artery lesions.BACKGROUND: Although the use of SES has proved to be effective in patients with simple coronary artery lesions, there are limited data of the long-term outcome of patients with complex coronary artery lesions.METHODS: We randomly assigned 322 patients with total coronary occlusions or lesions located in bifurcations, ostial, or angulated segments of the coronary arteries to have SES or BMS implanted.RESULTS: At 3 years, major adverse cardiac events had occurred in 20 patients (12%) in the SES group and in 59 patients (38%) in the BMS group (p < 0.001). Four versus 2 patients suffered a cardiac death (p = NS), and 5 versus 1 died of a noncardiac disease (p = NS) in the SES versus the BMS group. Six patients in the SES group versus 15 patients in the BMS group suffered a myocardial infarction (p < 0.05) during the 3-year observation period, and target lesion revascularization was performed in 8 patients (4.9%) versus 53 patients (33.8%), respectively (p < 0.001); of these, 4 in the SES versus 7 in the BMS group were performed between 1 and 3 years after the index treatment (p = NS). According to revised definitions, stent thrombosis occurred in 5 patients (3.1%) in the SES group and in 7 patients (4.4%) in the BMS group (p = NS); very late stent thrombosis was observed in 4 versus 1 patient.CONCLUSIONS: A continued benefit was observed up to 3 years after implantation of SES in patients with complex coronary artery lesions. The rate of late adverse events was similar in the 2 groups, and stent thromboses occurred rarely after 1 year. (Sirolimus Eluting Stents in Complex Coronary Lesions [SCANDSTENT]; NCT00151658)
KW - Aged
KW - Angioplasty, Balloon, Coronary
KW - Coronary Disease/mortality
KW - Coronary Restenosis/epidemiology
KW - Drug-Eluting Stents/adverse effects
KW - Female
KW - Fibrinolytic Agents/therapeutic use
KW - Follow-Up Studies
KW - Humans
KW - Kaplan-Meier Estimate
KW - Male
KW - Middle Aged
KW - Myocardial Infarction/epidemiology
KW - Sirolimus/administration & dosage
KW - Stents/adverse effects
KW - Treatment Outcome
U2 - 10.1016/j.jacc.2008.01.056
DO - 10.1016/j.jacc.2008.01.056
M3 - Journal article
C2 - 18498953
SN - 0735-1097
VL - 51
SP - 2011
EP - 2016
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 21
ER -