Long-term safety and efficacy of sirolimus-eluting stents versus bare-metal stents in real world clinical practice in Japan View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2011-05-12

AUTHORS

Takeshi Kimura, Takeshi Morimoto, Yutaka Furukawa, Yoshihisa Nakagawa, Kazushige Kadota, Masashi Iwabuchi, Satoshi Shizuta, Hiroki Shiomi, Tomohisa Tada, Junichi Tazaki, Yoshihiro Kato, Mamoru Hayano, Mitsuru Abe, Takashi Tamura, Manabu Shirotani, Shinji Miki, Mitsuo Matsuda, Mamoru Takahashi, Katsuhisa Ishii, Masaru Tanaka, Takeshi Aoyama, Osamu Doi, Ryuichi Hattori, Ryozo Tatami, Satoru Suwa, Akinori Takizawa, Yoshiki Takatsu, Masaaki Takahashi, Hiroshi Kato, Teruki Takeda, Jong-Dae Lee, Ryuji Nohara, Hisao Ogawa, Chuwa Tei, Minoru Horie, Hirofumi Kambara, Hisayoshi Fujiwara, Kazuaki Mitsudo, Masakiyo Nobuyoshi, Toru Kita

ABSTRACT

Long-term safety and efficacy of drug-eluting stents remains controversial. The CREDO-Kyoto registry cohort-2 is a physician-initiated non-company sponsored multi-center registry enrolling consecutive patients undergoing first coronary revascularization in 26 centers in Japan. We compared 3-year outcome between patients treated with sirolimus-eluting stent (SES) only (5092 patients) and bare-metal stent (BMS) only (5405 patients). SES-use as compared with BMS-use was associated with significantly lower adjusted risk for all-cause death [hazard ratio (HR) [95% confidence interval (CI)] 0.72 (0.59–0.87), P = 0.0007], which was mainly driven by the reduction in non-cardiac death [HR (95% CI) 0.64 (0.48–0.85), P = 0.002]. The risk of cardiac death [HR (95% CI) 0.82 (0.63–1.07), P = 0.15], myocardial infarction [HR (95% CI) 0.73 (0.51–1.03), P = 0.07] and definite stent thrombosis [HR (95% CI) 0.62 (0.35–1.09), P = 0.1] was not different between the two groups. Despite longer duration of thienopyridine administration, SES-use was associated with significantly lower risk for bleeding [HR (95% CI) 0.75 (0.6–0.95), P = 0.02] and similar risk for stroke [HR (95% CI) 1.0 (0.75–1.34), P = 1.0]. The risk for target-lesion revascularization (TLR) was markedly lower in the SES group [HR (95% CI) 0.42 (0.36–0.48), P < 0.0001]. The direction and magnitude of the effect of SES relative to BMS in patients presenting acute myocardial infarction (AMI) were similar to those in patients presenting otherwise. In conclusion, SES-use as compared with BMS-use was associated with marked reduction of TLR without any increases in death, myocardial infarction, stent thrombosis, stroke and bleeding in real world clinical practice regardless of clinical presentation including AMI. More... »

PAGES

234-245

Journal

Author Affiliations

  • Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin, Kawahara-cho, Sakkyo-ku, 606-8507, Kyoto, Japan
  • Center for Medical Education and Clinical Epidemiology Unit, Graduate School of Medicine, Kyoto University, Kyoto, Japan
  • Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
  • Division of Cardiology, Tenri Hospital, Tenri, Japan
  • Division of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan
  • Division of Cardiology, Kokura Memorial Hospital, Fukuoka, Japan
  • Division of Cardiology, Kyoto Medical Center, Kyoto, Japan
  • Division of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
  • Division of Cardiology, Nara Hospital, Kinki University Faculty of Medicine, Nara, Japan
  • Division of Cardiology, Mitsubishi Kyoto Hospital, Kyoto, Japan
  • Division of Cardiology, Kishiwada City Hospital, Kishiwada, Japan
  • Division of Cardiology, Shimabara Hospital, Kyoto, Japan
  • Division of Cardiology, Kansai Denryoku Hospital, Osaka, Japan
  • Division of Cardiology, Osaka Red Cross Hospital, Osaka, Japan
  • Division of Cardiology, Shimada Municipal Hospital, Shimada, Japan
  • Division of Cardiology, Shizuoka General Hospital, Shizuoka, Japan
  • Division of Cardiology, Maizuru Kyosai Hospital, Maizuru, Japan
  • Division of Cardiology, Juntendo University Shizuoka Hospital, Shizuoka, Japan
  • Division of Cardiology, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
  • Division of Cardiology, Hyogo Prefectural Amagasaki Hospital, Amagasaki, Japan
  • Division of Cardiology, Hamamatsu Rosai Hospital, Hamamatsu, Japan
  • Division of Cardiology, Nishi-Kobe Medical Center, Kobe, Japan
  • Division of Cardiology, Koto Memorial Hospital, Higashioumi, Japan
  • Division of Cardiology, University of Fukui Hospital, Fukui, Japan
  • Division of Cardiology, Kitano Hospital, Osaka, Japan
  • Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
  • Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University, Kagoshima, Japan
  • Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science Hospital, Otsu, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s12928-011-0065-0

    DOI

    http://dx.doi.org/10.1007/s12928-011-0065-0

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1053339460

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/24122590


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