Article Text

PDF
Target lesion revascularisation in patients treated with a sirolimus-eluting or paclitaxel-eluting stent
  1. Michael Maeng1,
  2. Lisette Okkels Jensen2,
  3. Klaus Rasmussen3,
  4. Jens Flensted Lassen1,
  5. Lars Romer Krusell1,
  6. Per Thayssen2,
  7. Leif Thuesen1
  1. 1Department of Cardiology, Skejby Sygehus, Aarhus University Hospital, Aarhus, Denmark
  2. 2Department of Cardiology, Odense University Hospital, Odense, Denmark
  3. 3Department of Cardiology, Aalborg Sygehus, Aalborg, Denmark
  1. Correspondence to:
    Dr M Maeng
    Department of Cardiology, Skejby Sygehus, Brendstrupgaardsvej, DK-8200 Aarhus N, Denmark; michael.maeng{at}ki.au.dk

Abstract

Objective: To identify risk factors for clinical-driven target lesion revascularisation (TLR) in patients treated with sirolimus-eluting (Cypher) or paclitaxel-eluting (Taxus) stents in a real-world scenario.

Design: From 1 January 2003 to 18 May 2005, all patients treated with a Cypher or Taxus stent were consecutively registered and followed for 9 months. Re-intervention was driven by clinical symptoms.

Setting: Western Denmark Heart Registry.

Patients: 4432 patients with 6102 lesions treated with a Cypher (n = 3791 lesions) or Taxus (n = 2311 lesions) stent.

Interventions: Percutaneous coronary intervention.

Main outcome measures: TLR, defined as either new percutaneous coronary intervention or coronary artery bypass graft operation of the target lesion, within 9 months from the index procedure.

Results: TLR within 9 months was performed in 2.5% of lesions treated with the Cypher stent and in 3.3% of lesions treated with the Taxus stent (OR 1.36, 95% CI 1.00 to 1.84). After adjustment by multivariate logistic regression, Taxus stent implantation was an independent predictor of TLR (OR 1.43, 95% CI 1.05 to 1.95). Implantation of >1 stent per lesion (OR 1.62, 95% CI 1.13 to 2.33) and reference diameter <2.8 mm (OR 1.42, 95% CI 1.00 to 2.02) were also identified as independent predictors of TLR.

Conclusions: These data from the registry reflect a real-world clinical scenario with operator-driven use of drug-eluting stents and symptom-driven re-intervention. In this setting, use of the Taxus stent, implantation of multiple stents per lesion and stent implantation in small vessels were independent predictors of TLR.

  • DES, drug-eluting stent
  • PCI, percutaneous coronary intervention
  • TLR, target lesion revascularisation

Statistics from Altmetric.com

Footnotes

  • Published Online First 23 December 2006

  • Competing interests: None declared.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.