April 2, 2008Angiology
Crush Stenting With Paclitaxel-Eluting or Sirolimus-Eluting Stents for the Treatment of Coronary Bifurcation Lesions
Key result
Sirolimus-eluting stents are linked to ~80% less main vessel restenosis vs paclitaxel-eluting stents in bifurcations.
- P=.004
- n=246
Why the study?
The comparative effectiveness and safety of paclitaxel-eluting versus sirolimus-eluting stents for crush stenting in coronary bifurcation lesions were not well established.
Does a sirolimus-eluting stent reduce restenosis and revascularization rates compared to a paclitaxel-eluting stent in patients with coronary bifurcation lesions undergoing crush stenting?
Comparison
Paclitaxel-eluting stent vs sirolimus-eluting stent for crush stenting
Design
Prospective nonrandomized cohort study
Follow-up
8-month
Authors
Discussion
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Member takes
Implication
Supports sirolimus-eluting stents for bifurcation crush stenting; hypothesis-generating and should not yet change practice.
Study Design
Type
Cohort (n=246)
Structured PICO
Does a sirolimus-eluting stent reduce restenosis and revascularization rates compared to a paclitaxel-eluting stent in patients with coronary bifurcation lesions undergoing crush stenting?
P
Population
246 patients with 252 coronary bifurcation lesions undergoing crush stenting with paclitaxel-eluting or sirolimus-eluting stents, followed for 8 months.
E
Exposure
Sirolimus-eluting stent for crush stenting
C
Comparator
Paclitaxel-eluting stent for crush stenting
O
Outcome
Late lumen loss, binary angiographic restenosis, target-lesion vessel revascularization, and cumulative major adverse cardiac events at 8-month follow-upcomposite
Main Result
Absolute Event Rate: 3.1% vs 15.7%
p-value: p=.004
For crush stenting of coronary bifurcation lesions, sirolimus-eluting stents yield significantly lower late lumen loss, restenosis, and revascularization rates compared to paclitaxel-eluting stents.
Cite This Study
Chen et al. (2008) conducted a cohort in Coronary bifurcation lesions (n=246). Sirolimus-eluting stent vs. Paclitaxel-eluting stent was evaluated on In-segment restenosis in the entire main vessel (p=.004). Sirolimus-eluting stents yielded significantly lower in-segment restenosis in the entire main vessel compared to paclitaxel-eluting stents (3.1% vs 15.7%, P=0.004) in coronary bifurcation lesions.