10-Year Clinical Outcome After Randomization to Treatment by Sirolimus- or Paclitaxel-Eluting Coronary Stents

Galløe, Anders; Kelbæk, Henning; Thuesen, Leif; Hansen, Henrik Steen; Ravkilde, Jan; Hansen, Peter Riis; Christiansen, Evald Høj; Abildgaard, Ulrik; Stephansen, Ghita B.; Lassen, Jens Flensted; Engstrøm, Thomas; Jensen, Jan Skov; Jeppesen, Jørgen; Bligaard, Niels; Investigators, Sort Out Ii

doi:10.1016/j.jacc.2016.11.055

Cited by 68 publications

(35 citation statements)

References 32 publications

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“…Ten-year outcomes of SORT OUT II trial showed a steady annual rate of 1.3% in definite, probable and possible ST after the 1 st year. [23] Patients received G1-DES need for continuous surveillance for ST.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Efficacy and Safety between First and Second Generation Drug-eluting Stents in Patients with Stable Coronary Artery Disease

Liu

Xiong

Wen

et al. 2017

Chinese Medical Journal

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Background:Lots of trials demonstrate that second-generation drug-eluting stents (G2-DES), with their improved properties, offer significantly superior efficacy and safety profiles compared to first generation DES (G1-DES) for patients with coronary artery disease (CAD) receiving percutaneous coronary intervention (PCI). This study aimed to verify the advantage of G2-DES over G1-DES in Chinese patients with stable CAD (SCAD).Methods:For this retrospective observational analysis, 2709 SCAD patients with either G1-DES (n = 863) or G2-DES (n = 1846) were enrolled consecutively throughout 2013. Propensity score matching (PSM) was applied to control differing baseline factors. Two-year outcomes, including major adverse coronary events as well as individual events, including target vessel-related myocardial infarction, target lesion revascularization (TLR), target vessel revascularization, and cardiogenic death were evaluated.Results:The incidence of revascularization between G1- and G2-DES showed a trend of significant difference with a threshold P - value (8.6% vs. 6.7%, χ2 = 2.995, P = 0.084). G2-DES significantly improved TLR-free survival compared to G1-DES (96.6% vs. 97.9%, P = 0.049) and revascularization-free survival curve showed a trend of improvement of G2-DES (92.0% vs. 93.8%, P = 0.082). These differences diminished after PSM. Multivariate Cox proportional hazard regression analysis showed a trend for G1-associated increase in revascularization (hazard ratio: 1.28, 95% confidence interval: 0.95–1.72, P = 0.099) while no significance was found after PSM. Other endpoints showed no significant differences after multivariate adjustment regardless of PSM.Conclusions:G1-DES showed the same safety as G2-DES in this large Chinese cohort of real-world patients. However, G2-DES improved TLR-free survival of SCAD patients 2 years after PCI. The advantage was influenced by baseline clinical factors. G1-DES was associated with a trend of increase in revascularization risk and was not an independent predictor of worse medium-term prognosis compared with G2-DES.

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Section: Discussionmentioning

confidence: 99%

Comparison of Efficacy and Safety between First and Second Generation Drug-eluting Stents in Patients with Stable Coronary Artery Disease

Liu

Xiong

Wen

et al. 2017

Chinese Medical Journal

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“…Overall, the results from a series of TAXUS trials support the long‐term safety of the TAXUS stent system; nonetheless, a number of prothrombotic effects have been confirmed in vitro. A recent study concluded that the majority of the patients (73%) randomized to be treated by first‐generation DES survived for 10 years and clinical follow‐ups of patients receiving sirolimus versus PES confirmed that there were no significant differences over 10 years in terms of survival or rates of a major adverse cardiac event or stent thrombosis …”

Section: Des To Achieve Reduced Restenosis and Prevent Isrmentioning

confidence: 99%

“…42 A recent study concluded that the majority of the patients (73%) randomized to be treated by first-generation DES survived for 10 years and clinical follow-ups of patients receiving sirolimus versus PES confirmed that there were no significant differences over 10 years in terms of survival or rates of a major adverse cardiac event or stent thrombosis. 43 Another ENDEAVOR IV (Randomized Comparison of Zotarolimus-…”

Section: Des To Achieve Reduced Restenosis and Prevent Isrmentioning

confidence: 99%

Stent‐mediated gene and drug delivery for cardiovascular disease and cancer: A brief insight

Krishnagopal

Reddy

Sen

2017

The Journal of Gene Medicine

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This review concisely recapitulates the different existing modes of stent-mediated gene/drug delivery, their considerable advancement in clinical trials and a rationale for other merging new technologies such as nanotechnology and microRNA-based therapeutics, in addition to addressing the limitations in each of these perpetual stent platforms. Over the past decade, stent-mediated gene/drug delivery has materialized as a hopeful alternative for cardiovascular disease and cancer in contrast to routine conventional treatment modalities. Regardless of the phenomenal recent developments achieved by coronary interventions and cancer therapies that employ gene and drug-eluting stents, practical hurdles still remain a challenge. The present review highlights the limitations that each of the existing stent-based gene/drug delivery system encompasses and therefore provides a vision for the future with respect to discovering an ideal stent therapeutic platform that would circumvent all the practical hurdles witnessed with the existing technology. Further study of the improvisation of next-generation drug-eluting stents has helped to overcome the issue of restenosis to some extent. However, current stent formulations fall short of the anticipated clinically meaningful outcomes and there is an explicit need for more randomized trials aiming to further evaluate stent platforms in favour of enhanced safety and clinical value. Gene-eluting stents may hold promise in contributing new ideas for stent-based prevention of in-stent restenosis through genetic interventions by capitalizing on a wide variety of molecular targets. Therefore, the central consideration directs us toward finding an ideal stent therapeutic platform that would tackle all of the gaps in the existing technology.

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“…2 The stent style including bare-metal stents (BMS) and drug-eluting stents (DES) benefited many patients in clinic. 3 Antiplatelet therapy is standard treatment after PCI. Meanwhile, international guidelines and clinical practice recommend dual antiplatelet therapy (DAPT aspirin combination with P2Y12 inhibitors) after PCI.…”

Section: Introductionmentioning

confidence: 99%

The Development of Antiplatelet Therapy after Percutaneous Coronary Intervention

Duan

Gong

2017

IPMRJ

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Coronary artery disease is one of the common cardiovascular diseases and threatens our health. Percutaneous coronary intervention (PCI) is the main treatment for coronary artery disease. Bare-metal stents (BMS) and drug-eluting stents (DES) are popularly applied in clinical practice. With the development of clinic and technology, DES is widely used in coronary artery disease following antiplatelet therapy. Clinical guidelines require dual antiplatelet therapy (DAPT) after PCI in USA and Europe. It is effective to reduce the incident of stent thrombosis, myocardial infarction and major adverse cardiac. However, the risk of major adverse cardiac events and bleeding was increased by DAPT. Therefore, single antiplatelet therapy was induced in various clinical trials. We searched previous research from PubMed, Embase Web of Science

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10-Year Clinical Outcome After Randomization to Treatment by Sirolimus- or Paclitaxel-Eluting Coronary Stents

Cited by 68 publications

References 32 publications

Comparison of Efficacy and Safety between First and Second Generation Drug-eluting Stents in Patients with Stable Coronary Artery Disease

Comparison of Efficacy and Safety between First and Second Generation Drug-eluting Stents in Patients with Stable Coronary Artery Disease

Stent‐mediated gene and drug delivery for cardiovascular disease and cancer: A brief insight

The Development of Antiplatelet Therapy after Percutaneous Coronary Intervention

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