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2-year clinical outcomes after implantation of sirolimus-eluting, paclitaxel-eluting, and bare-metal coronary stents: results from the WDHR (Western Denmark Heart Registry).

https://arctichealth.org/en/permalink/ahliterature89935
Source
J Am Coll Cardiol. 2009 Feb 24;53(8):658-64
Publication Type
Article
Date
Feb-24-2009
Author
Kaltoft Anne
Jensen Lisette Okkels
Maeng Michael
Tilsted Hans Henrik
Thayssen Per
Bøttcher Morten
Lassen Jens Flensted
Krusell Lars Romer
Rasmussen Klaus
Hansen Knud Nørregaard
Pedersen Lars
Johnsen Søren Paaske
Sørensen Henrik Toft
Thuesen Leif
Author Affiliation
Department of Cardiology, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark. annekaltoft@stofanet.dk
Source
J Am Coll Cardiol. 2009 Feb 24;53(8):658-64
Date
Feb-24-2009
Language
English
Publication Type
Article
Keywords
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Disease - mortality - therapy
Drug-Eluting Stents - adverse effects
Female
Humans
Immunosuppressive Agents
Male
Middle Aged
Myocardial Infarction - etiology
Paclitaxel
Sirolimus
Stents - adverse effects
Thrombosis - etiology
Abstract
OBJECTIVES: This registry study assessed the safety and efficacy of the 2 types of drug-eluting stents (DES), sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES), compared with bare-metal stents (BMS). BACKGROUND: Drug-eluting stents may increase the risk of stent thrombosis (ST), myocardial infarction (MI), and death. METHODS: A total of 12,395 consecutive patients with coronary intervention and stent implantation recorded in the Western Denmark Heart Registry from January 2002 through June 2005 were followed up for 2 years. Data on death and MI were ascertained from national medical databases. We used Cox regression analysis to control for confounding. RESULTS: The 2-year incidence of definite ST was 0.64% in BMS patients, 0.79% in DES patients (adjusted relative risk [RR]: 1.09; 95% confidence interval [CI]: 0.72 to 1.65), 0.50% in SES patients (adjusted RR: 0.63, 95% CI: 0.35 to 1.15), and 1.30% in PES patients (adjusted RR: 1.82, 95% CI: 1.13 to 2.94). The incidence of MI was 3.8% in BMS-treated patients, 4.5% in DES-treated patients (adjusted RR: 1.24, 95% CI: 1.02 to 1.51), 4.1% in SES-treated patients (adjusted RR: 1.15, 95% CI: 0.91 to 1.47), and 5.3% in PES-treated patients (adjusted RR: 1.38, 95% CI: 1.06 to 1.81). Whereas overall 2-year adjusted mortality was similar in the BMS and the 2 DES stent groups, 12- to 24-month mortality was higher in patients treated with PES (RR 1.46, 95% CI: 1.02 to 2.09). Target lesion revascularization was reduced in both DES groups. CONCLUSIONS: During 2 years of follow-up, patients treated with PES had an increased risk of ST and MI compared with those treated with BMS and SES. Mortality after 12 months was also increased in PES patients.
Notes
Comment In: J Am Coll Cardiol. 2009 Feb 24;53(8):665-619232898
PubMed ID
19232897 View in PubMed
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Comparison of stent thrombosis, myocardial infarction, and mortality following drug-eluting versus bare-metal stent coronary intervention in patients with diabetes mellitus.

https://arctichealth.org/en/permalink/ahliterature85978
Source
Am J Cardiol. 2008 Jul 15;102(2):165-72
Publication Type
Article
Date
Jul-15-2008
Author
Maeng Michael
Jensen Lisette O
Kaltoft Anne
Hansen Hans H T
Bøttcher Morten
Lassen Jens F
Thayssen Per
Krusell Lars R
Rasmussen Klaus
Pedersen Lars
Sørensen Henrik T
Johnsen Søren P
Thuesen Leif
Author Affiliation
Department of Cardiology, Skejby Sygehus, Aarhus University Hospital, Aarhus, Denmark.
Source
Am J Cardiol. 2008 Jul 15;102(2):165-72
Date
Jul-15-2008
Language
English
Publication Type
Article
Abstract
The aim of this study was to examine outcomes subsequent to implantation of drug-eluting stents (DESs) and bare-metal stents (BMSs) in patients with diabetes. From January 2002 to June 2005, data from all percutaneous coronary interventions performed in Western Denmark were prospectively recorded. A total of 1,423 consecutive diabetic patients treated with stent implantation (2,094 lesions) were followed up for 15 months. Of these, 871 patients (1,180 lesions) were treated with a BMS, and 552 patients (914 lesions) were treated with a DES. Dual antiplatelet therapy was recommended for 12 months in both treatment groups. Data for death and myocardial infarction (MI) were ascertained from national health care databases. Use of DESs was not associated with increased risk of definite stent thrombosis (adjusted relative risk [RR] 0.76, 95% confidence interval [CI] 0.10 to 3.26) or MI (adjusted RR 0.90, 95% CI 0.53 to 1.52). In the DES group compared with the BMS group, adjusted RRs of target-lesion revascularization (adjusted RR 0.48, 95% CI 0.33 to 0.71), total mortality (adjusted RR 0.66, 95% CI 0.44 to 0.99), and cardiac mortality (adjusted RR 0.53, 95% CI 0.31 to 0.90) decreased by 52%, 34%, and 47%, respectively. In conclusion, use of DESs reduced target-lesion revascularization in diabetic patients receiving routine clinical care. This result was obtained without increased risk of death, stent thrombosis, or MI.
PubMed ID
18602515 View in PubMed
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[Drug-eluting stents in percutaneous coronary intervention. The Danish Society of Cardiology]

https://arctichealth.org/en/permalink/ahliterature93347
Source
Ugeskr Laeger. 2008 Mar 17;170(12):1019
Publication Type
Article
Date
Mar-17-2008
Author
Jensen Lisette Okkels
Thayssen Per
Kaltoft Anne K
Hansen Hans-Henrik Tilsted
Thuesen Leif
Author Affiliation
Kardiologisk Laboratorium, Odense Universitetshospital, DK-5000 Odense C. okkels@dadlnet.dk
Source
Ugeskr Laeger. 2008 Mar 17;170(12):1019
Date
Mar-17-2008
Language
Danish
Publication Type
Article
Keywords
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Restenosis - epidemiology
Denmark - epidemiology
Drug-Eluting Stents
Follow-Up Studies
Humans
Outcome Assessment (Health Care)
PubMed ID
18397637 View in PubMed
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Paclitaxel and sirolimus eluting stents versus bare metal stents: long-term risk of stent thrombosis and other outcomes. From the Western Denmark Heart Registry.

https://arctichealth.org/en/permalink/ahliterature99564
Source
EuroIntervention. 2010 Apr;5(8):898-905
Publication Type
Article
Date
Apr-2010
Author
Jensen Lisette Okkels
Tilsted Hans Henrik
Thayssen Per
Kaltoft Anne
Maeng Michael
Lassen Jens Flensted
Hansen Knud Noerregaard
Madsen Morten
Ravkilde Jan
Johnsen Søren Paaske
Sørensen Henrik Toft
Thuesen Leif
Author Affiliation
Department of Cardiology, Odense University Hospital, Denmark. okkels@dadlnet.dk
Source
EuroIntervention. 2010 Apr;5(8):898-905
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Aged
Angioplasty, Transluminal, Percutaneous Coronary - adverse effects - instrumentation - mortality
Cardiovascular Agents - administration & dosage
Chi-Square Distribution
Coronary Artery Disease - mortality - therapy
Denmark - epidemiology
Drug-Eluting Stents
Female
Follow-Up Studies
Humans
Incidence
Kaplan-Meiers Estimate
Male
Metals
Middle Aged
Myocardial Infarction - etiology
Paclitaxel - administration & dosage
Platelet Aggregation Inhibitors - therapeutic use
Proportional Hazards Models
Prosthesis Design
Registries
Risk assessment
Risk factors
Sirolimus - administration & dosage
Stents
Thrombosis - etiology - mortality
Time Factors
Treatment Outcome
Abstract
AIMS: Stent thrombosis is a serious complication of percutaneous coronary intervention (PCI). We examined the incidence of stent thrombosis and other outcomes in patients treated with PCI and paclitaxeleluting stents (PES), sirolimus-eluting stents (SES) or bare-metal stents (BMS). METHODS AND RESULTS: All patients who underwent PES, SES or BMS implantation from January 2002 to June 2005 were identified in the population-based Western Denmark Heart Registry. All were followed for 36 months. Cox regression analysis was used to estimate relative risk (RR), controlling for covariates. A total of 12,374 patients were treated with stents: 1,298 with PES, 2,202 with SES and 8,847 with BMS. The three-year incidence of definite stent thrombosis was similar in the DES group (1.1%) and in the BMS group (0.7%) (adjusted relative risk [RR]: 1.24; 95% confidence interval [CI]: 0.85-1.81). Very late definite stent thrombosis occurred more frequently in DES-treated patients (adjusted RR: 2.89, 95% CI: 1.48- 5.65). The three-year mortality rate did not differ significantly between the two groups. Target lesion revascularisation (TLR) was lower in DES-treated patients than in BMS-treated patients (adjusted RR: 0.71, 95% CI: 0.63-0.81). CONCLUSIONS: An increased risk of very late definite stent thrombosis was observed in DES-treated patients compared with BMS-treated patients, but a similar mortality was detected. TLR continued to be lower among patients receiving DES.
PubMed ID
20542774 View in PubMed
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