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Studies show everolimus-eluting stent implantation reduces restenosis and repeat revasculariztion
Date:10/21/2010

alcified culprit lesions than BMS implantation.

In a related study, researchers from the Wake Forrest University School of Medicine in North Carolina analyzed data from SPIRIT III clinical trial to evaluate whether EES, with thinner stent struts and polymer, results in less adverse outcomes. Findings from the SPIRIT III trial indicated that the newer generation of DES, the EES, was associated with fewer clinical events than the first generation PES. In an effort to determine whether this benefit extended to all patient subgroups, Robert Applegate, MD, FSCAI, and colleagues assessed the impact of jailed side branches on clinical outcomes and periprocedural myonecrosis within each stent treatment group.

The Wake Forest researchers identified 113 patients in the EES group and 63 patients in the PES group who met the criteria of having a lesion with a jailed side branch (less than 2 mm diameter, and less than 50% stenosis). Two-year clinical outcomes were evaluated, revealing that MACE (cardiac death, myocardial infarctions (MI), or TLR) occurred in 6.8% of EES and 19.0% of PES jailed side branch patients, with numerically lower rates of MI and TLR in the EES group, with comparable rates of cardiac death.

Use of a PES was associated with an increase in rates of periprocedural creatine kinase-MB fraction (CK-MB) elevation, which was most prevalent in those patients with a jailed side branch. In contrast, rates of CK-MB elevation were similar in those patients receiving an EES, and lower when compared to PES, regardless of the presence or absence of a jailed side branch. The clinical outcomes at 1 and 2 years were similar in the EES treated patients with and without a jailed side branch, but were numerically higher in the PES treated patients with a jailed side branch compared to those without a jailed side branch.

Dr. Applegate concluded, "Our observations confirm previous studies demonstrating a relative increase in the incidence
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Contact: Dawn Peters
healthnews@wiley.com
781-388-8408
Wiley-Blackwell
Source:Eurekalert

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