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Target Lesion Revascularization in Patients Treated With a Sirolimus-eluting or Paclitaxel-eluting stent
  1. Michael Maeng (michael.maeng{at}ki.au.dk)
  1. Skejby Hospital, Aarhus University Hospital, Denmark
    1. Lisette Okkels Jensen (okkels{at}dadlnet.dk)
    1. Odense University Hospital, Denmark
      1. Klaus Rasmussen (kr{at}aas.nja.dk)
      1. Aalborg University Hospital, Denmark
        1. Jens Flensted Lassen (jensfl{at}dadlnet.dk)
        1. Skejby Hospital, Aarhus University Hospital, Denmark
          1. Lars Romer Krusell (lrk{at}sks.aaa.dk)
          1. Skejby Hospital, Aarhus University Hospital, Denmark
            1. Per Thayssen (per.thayssen{at}ouh.fyns-amt.dk)
            1. Odense University Hospital, Denmark
              1. Leif Thuesen (leif.thuesen{at}ki.au.dk)
              1. Skejby Hospital, Aarhus University Hospital, Denmark

                Abstract

                Objective We sought to identify risk factors for clinical driven target lesion revascularization (TLR) in patients treated with Sirolimus-eluting (Cypher) or paclitaxel-eluting (Taxus) stents in a real-world scenario.

                Design From January 1, 2003 to May 18, 2005, all patients treated with a Cypher or Taxus 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) 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 (odds ratio (OR) 1.36, 95% confidence interval (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 registry data reflects 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.

                • Drug-eluting stents
                • Paclitaxel
                • Registry
                • Restenosis
                • Sirolimus

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