Authors: Paolo Buja Davide Lanzellotti Giambattista Isabella Massimo Napodano Marco Panfili Enrico Favaretto Sabino Iliceto Giuseppe Tarantini
Publish Date: 2011/10/12
Volume: 27, Issue: 6, Pages: 553-558
Abstract
The treatment of elderly patients with coronary artery disease CAD is challenging because this population is complex and greatly expanding Drugeluting stents DES generally improve the outcome in highrisk cases We evaluated the clinical impact of different firstgeneration DES ie sirolimuseluting stents SES and paclitaxeleluting stents PES in this context A prospective nonrandomized singlecenter allcomers registry consecutively enrolling all patients aged ≥75 years eligible for percutaneous coronary intervention PCI with DES was carried out Only one type of DES was implanted per protocol for each patient Two groups were identified according to the type of implanted stent ie SES and PES The primary end point encompassed major adverse cardiac events MACE including death myocardial infarction and target lesion revascularization TLR The secondary end point encompassed the rate of definite/probable stent thrombosis and target vessel revascularization TVR From June 2004 to May 2008 151 patients were enrolled Among them 112 742 received SES and 39 258 received PES Baseline clinical characteristics were similar while few angiographic features ostial location stent diameter proximal reference vessel diameter showed minor differences At the median followup of 226 months primary and secondary end points did not significantly differ in terms of MACE SES 125 vs PES 205 P = 03 death SES 54 vs PES 77 P = 07 myocardial infarction SES 45 vs PES 103 P = 02 TLR SES 27 vs PES 26 P = 10 stent thrombosis SES 18 vs PES 51 P = 03 and TVR SES 18 vs PES 0 P = 06 In this realworld population of elderly patients treated by DES–PCI for CAD the overall efficacy and safety have been excellent in both DES and the choice between SES and PES did not influence the clinical outcome
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