OBJECTIVES: We compared the long-term outcomes of drug-eluting stents (DES) versus bare-metal stents (BMS) for treatment of bare-metal in-stent restenosis (ISR). BACKGROUND: There are no randomized trials or observational studies directly comparing the safety and efficacy of DES versus BMS for treatment of bare-metal ISR. METHODS: We examined data on all patients who underwent percutaneous coronary intervention (PCI) for ISR at Cleveland Clinic between 05/1999 and 06/2007. We compared the efficacy and safety of DES to BMS for treating bare-metal ISR. The primary end point was a composite of death, myocardial infarction (MI), or target lesion revascularization (TLR). The secondary endpoints were individual components of the primary endpoint. RESULTS: Of the 931 patients identified over 8 years, 706 had bare-metal ISR and met our study criteria. Of the 706 patients with bare-metal ISR, 362 were treated with DES and 344 with BMS. There were 230 cumulative events for a median follow-up of 3.2 years. After adjusting for 27 variables, DES were associated with lower primary endpoint compared to BMS for treatment of bare-metal ISR (21% vs. 45%, adjusted hazard ratio [HR] 0.63; 95% confidence interval [CI], 0.42-0.95; P = 0.03). The individual secondary endpoint of death (8% vs. 24%, P = 0.005) favored DES, but MI (3% vs. 8%, P = 0.31), and TLR (13% vs. 20%, P = 0.23) failed to reach statistical significance. CONCLUSIONS: In our multivariate analysis of patients with bare-metal ISR, DES use was associated with significantly lower death, MI, or TLR when compared to BMS. (c) 2010 Wiley-Liss, Inc.
OBJECTIVES: We compared the long-term outcomes of drug-eluting stents (DES) versus bare-metal stents (BMS) for treatment of bare-metal in-stent restenosis (ISR). BACKGROUND: There are no randomized trials or observational studies directly comparing the safety and efficacy of DES versus BMS for treatment of bare-metal ISR. METHODS: We examined data on all patients who underwent percutaneous coronary intervention (PCI) for ISR at Cleveland Clinic between 05/1999 and 06/2007. We compared the efficacy and safety of DES to BMS for treating bare-metal ISR. The primary end point was a composite of death, myocardial infarction (MI), or target lesion revascularization (TLR). The secondary endpoints were individual components of the primary endpoint. RESULTS: Of the 931 patients identified over 8 years, 706 had bare-metal ISR and met our study criteria. Of the 706 patients with bare-metal ISR, 362 were treated with DES and 344 with BMS. There were 230 cumulative events for a median follow-up of 3.2 years. After adjusting for 27 variables, DES were associated with lower primary endpoint compared to BMS for treatment of bare-metal ISR (21% vs. 45%, adjusted hazard ratio [HR] 0.63; 95% confidence interval [CI], 0.42-0.95; P = 0.03). The individual secondary endpoint of death (8% vs. 24%, P = 0.005) favored DES, but MI (3% vs. 8%, P = 0.31), and TLR (13% vs. 20%, P = 0.23) failed to reach statistical significance. CONCLUSIONS: In our multivariate analysis of patients with bare-metal ISR, DES use was associated with significantly lower death, MI, or TLR when compared to BMS. (c) 2010 Wiley-Liss, Inc.
Authors: Sang-Wook Kim; Gary S Mintz; Esteban Escolar; Patrick Ohlmann; Jerzy Pregowski; Pawel Tyczynski; Salah-Eddine Hassani; Augusto D Pichard; Lowell F Satler; Kenneth M Kent; William O Suddath; Ron Waksman; Neil J Weissman Journal: Am J Cardiol Date: 2006-03-13 Impact factor: 2.778
Authors: Spencer B King; Sidney C Smith; John W Hirshfeld; Alice K Jacobs; Douglass A Morrison; David O Williams; Ted E Feldman; Morton J Kern; William W O'Neill; Hartzell V Schaff; Patrick L Whitlow; Cynthia D Adams; Jeffrey L Anderson; Christopher E Buller; Mark A Creager; Steven M Ettinger; Jonathan L Halperin; Sharon A Hunt; Harlan M Krumholz; Frederick G Kushner; Bruce W Lytle; Rick Nishimura; Richard L Page; Barbara Riegel; Lynn G Tarkington; Clyde W Yancy Journal: J Am Coll Cardiol Date: 2008-01-15 Impact factor: 24.094
Authors: Michael S Lee; Antonio Pessegueiro; Raymond Zimmer; Daniel Jurewitz; Jonathan Tobis Journal: J Invasive Cardiol Date: 2008-08 Impact factor: 2.022
Authors: David R Holmes; Paul Teirstein; Lowell Satler; Michael Sketch; James O'Malley; Jeffery J Popma; Richard E Kuntz; Peter J Fitzgerald; Hong Wang; Eileen Caramanica; Sidney A Cohen Journal: JAMA Date: 2006-03-12 Impact factor: 56.272
Authors: Inder M Singh; Steven J Filby; Fredy El Sakr; Eiran Z Gorodeski; A Michael Lincoff; Stephen G Ellis; Mehdi H Shishehbor Journal: Catheter Cardiovasc Interv Date: 2010-02-15 Impact factor: 2.692
Authors: Stephen G Ellis; Charles D O'Shaughnessy; Steven L Martin; Kenneth Kent; Thomas McGarry; Mark A Turco; Dean J Kereiakes; Jeffrey J Popma; Mark Friedman; Joerg Koglin; Gregg W Stone Journal: Eur Heart J Date: 2008-06-13 Impact factor: 29.983
Authors: Paolo Izzo; Andrea Macchi; Luisa De Gennaro; Antonio Gaglione; Matteo Di Biase; Natale Daniele Brunetti Journal: Eur Heart J Acute Cardiovasc Care Date: 2012-06