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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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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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Randomized study on simple versus complex stenting of coronary artery bifurcation lesions: the Nordic bifurcation study.

https://arctichealth.org/en/permalink/ahliterature80096
Source
Circulation. 2006 Oct 31;114(18):1955-61
Publication Type
Article
Date
Oct-31-2006
Author
Steigen Terje K
Maeng Michael
Wiseth Rune
Erglis Andrejs
Kumsars Indulis
Narbute Inga
Gunnes Pål
Mannsverk Jan
Meyerdierks Oliver
Rotevatn Svein
Niemelä Matti
Kervinen Kari
Jensen Jan S
Galløe Anders
Nikus Kjell
Vikman Saila
Ravkilde Jan
James Stefan
Aarøe Jens
Ylitalo Antti
Helqvist Steffen
Sjögren Iwar
Thayssen Per
Virtanen Kari
Puhakka Mikko
Airaksinen Juhani
Lassen Jens F
Thuesen Leif
Author Affiliation
Department of Cardiology, University Hospital of Tromsoe, Tromsoe, Norway.
Source
Circulation. 2006 Oct 31;114(18):1955-61
Date
Oct-31-2006
Language
English
Publication Type
Article
Keywords
Coronary Angiography
Coronary Stenosis - epidemiology - radiography - surgery
Female
Follow-Up Studies
Humans
Male
Middle Aged
Sirolimus - administration & dosage - therapeutic use
Stents
Treatment Outcome
Abstract
BACKGROUND: The optimal stenting strategy in coronary artery bifurcation lesions is unknown. In the present study, a strategy of stenting both the main vessel and the side branch (MV+SB) was compared with a strategy of stenting the main vessel only, with optional stenting of the side branch (MV), with sirolimus-eluting stents. METHODS AND RESULTS: A total of 413 patients with a bifurcation lesion were randomized. The primary end point was a major adverse cardiac event: cardiac death, myocardial infarction, target-vessel revascularization, or stent thrombosis after 6 months. At 6 months, there were no significant differences in rates of major adverse cardiac events between the groups (MV+SB 3.4%, MV 2.9%; P=NS). In the MV+SB group, there were significantly longer procedure and fluoroscopy times, higher contrast volumes, and higher rates of procedure-related increases in biomarkers of myocardial injury. A total of 307 patients had a quantitative coronary assessment at the index procedure and after 8 months. The combined angiographic end point of diameter stenosis >50% of main vessel and occlusion of the side branch after 8 months was found in 5.3% in the MV group and 5.1% in the MV+SB group (P=NS). CONCLUSIONS: Independent of stenting strategy, excellent clinical and angiographic results were obtained with percutaneous treatment of de novo coronary artery bifurcation lesions with sirolimus-eluting stents. The simple stenting strategy used in the MV group was associated with reduced procedure and fluoroscopy times and lower rates of procedure-related biomarker elevation. Therefore, this strategy can be recommended as the routine bifurcation stenting technique.
PubMed ID
17060387 View in PubMed
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Target lesion revascularisation in patients treated with a sirolimus-eluting or paclitaxel-eluting stent.

https://arctichealth.org/en/permalink/ahliterature79290
Source
Heart. 2007 Jun;93(6):694-7
Publication Type
Article
Date
Jun-2007
Author
Maeng Michael
Okkels Jensen Lisette
Rasmussen Klaus
Flensted Lassen Jens
Romer Krusell Lars
Thayssen Per
Thuesen Leif
Author Affiliation
Department of Cardiology, Skejby Sygehus, Aarhus University Hospital, Aarhus, Denmark. michael.maeng@ki.au.dk
Source
Heart. 2007 Jun;93(6):694-7
Date
Jun-2007
Language
English
Publication Type
Article
Keywords
Analysis of Variance
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Restenosis - epidemiology - therapy
Coronary Stenosis - therapy
Denmark
Drug Delivery Systems
Equipment Design
Humans
Logistic Models
Paclitaxel - administration & dosage
Registries
Risk factors
Sirolimus - administration & dosage
Stents
Treatment Outcome
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
PubMed ID
17194711 View in PubMed
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Timing, causes, and predictors of death after three years' follow-up in the Danish Multicenter Randomized Study of Fibrinolysis versus Primary Angioplasty in Acute Myocardial Infarction (DANAMI-2) trial.

https://arctichealth.org/en/permalink/ahliterature88504
Source
Am J Cardiol. 2009 Jul 15;104(2):210-5
Publication Type
Article
Date
Jul-15-2009
Author
Busk Martin
Maeng Michael
Kristensen Steen D
Thuesen Leif
Krusell Lars R
Mortensen Leif S
Steinmetz Ebbe R
Nielsen Torsten T
Andersen Henning R
Author Affiliation
Department of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark.
Source
Am J Cardiol. 2009 Jul 15;104(2):210-5
Date
Jul-15-2009
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Aged
Angioplasty, Balloon - statistics & numerical data
Anticoagulants - therapeutic use
Aspirin - therapeutic use
Confidence Intervals
Denmark
Drug-Eluting Stents
Exercise Test
Female
Fibrinolytic Agents - therapeutic use
Heparin - therapeutic use
Humans
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction - drug therapy - mortality - therapy
Platelet Aggregation Inhibitors - therapeutic use
Prospective Studies
Risk factors
Stroke Volume
Tissue Plasminogen Activator - therapeutic use
Ventricular Function, Left
Abstract
This study evaluated the timing, causes, and predictors of death during long-term follow-up after primary angioplasty with stent implantation versus in-hospital fibrinolysis with a tissue plasminogen activator (alteplase). We randomized 1,572 patients with ST-elevation myocardial infarction to primary angioplasty or alteplase and followed them for 3 years. The causes of death were prospectively assessed by an end point committee unaware of the study treatment. A total of 225 patients (14.3%) died, 113 within the first 30 days and 112 between 31 days and 3 years. The mortality and causes of death did not differ between the 2 treatments. The causes of death were cardiogenic shock/congestive heart failure (41%), sudden death (17%), other cardiac death (10%), cancer (12%), and other noncardiac death (20%). Cardiac death was predominant during the first month only (86% of early deaths), and noncardiac death and cardiac death were equally frequent after 30 days (49% and 51% of late deaths, respectively). Independent predictors of death after discharge were age, left ventricular ejection fraction, diabetes, Killip class, and a lack of treatment with a beta blocker or statin. In conclusion, the causes of death did not differ between alteplase treatment and primary angioplasty with stent implantation. One half of the deaths within 3 years after ST-elevation myocardial infarction occurred during the first 30 days, and cardiac death was predominant during the first 30 days only.
PubMed ID
19576349 View in PubMed
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6 records – page 1 of 1.