Key result
Everolimus-eluting stents demonstrated a 2-year major adverse cardiac event rate of 10.6% in a real-world, high-risk population of 500 unselected patients.
Cohort (n=500)
Everolimus-eluting stents demonstrate acceptable safety and efficacy in a real-world, high-risk population with complex lesions, supporting their use in off-label situations.
Supports consideration in complex lesions; extends real-world data but leaves open randomized confirmation for off-label use.
AIMS: To investigate the safety and efficacy of everolimus-eluting stents (EES) in a real world population, including those with high-risk characteristics and complex lesions. METHODS: In this report, we analyze 2-year outcomes in 500 consecutive unselected patients treated with EES between April 2007 and March 2008. All patients were followed for 2 years for adverse events. RESULTS: There were 995 EES deployed in 792 lesions. The indication for the coronary procedure was acute coronary syndrome in 94.2% of patients. Bifurcations were involved in 21% of lesions, 3.5% degenerated vein grafts, 2.7% left main stem stenoses, 33% multivessel disease, 4.5% in-stent restenosis, and 79.1% AHA/ACC classification B2/C lesions. The major adverse cardiac event rate (composite of cardiovascular death, acute myocardial infarction, target lesion revascularization) was 10.6%. Target lesion revascularization was required in 4.0% patients, 1.4% for in-stent thrombosis. These event rates are comparable with studies involving lower risk patients and less complex coronary lesions. CONCLUSION: The use of EES, even in this real world, high-risk population, continues to demonstrate safety and efficacy rates comparable with current studies in more selected patient groups and, therefore, may justify current practice to utilize EES in "off label" situations.
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Aldous et al. (2011) conducted a cohort in Coronary artery disease (predominantly acute coronary syndrome) (n=500). Everolimus-eluting stents (EES) was evaluated on Major adverse cardiac event (composite of cardiovascular death, acute myocardial infarction, target lesion revascularization). Everolimus-eluting stents demonstrated a 2-year major adverse cardiac event rate of 10.6% in a real-world, high-risk population of 500 unselected patients.
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