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Periprocedural and Late Consequences of Overlapping Cypher Sirolimus-Eluting Stents

Pooled Analysis of Five Clinical Trials

Dean J. Kereiakes, MD, FACC^_*,_*, Hong Wang, MD, MPH^,a, Jeffrey J. Popma, MD, Richard E. Kuntz, MD^,d, Dennis J. Donohoe, MD^,a, Joachim Schofer, MD, Erick Schampaert, MD^||, Bernhard Meier, MD, FESC, FACC^¶,b, Martin B. Leon, MD, FACC^#,c and Jeffrey W. Moses, MD, FACC^#

^_* Heart Center of Greater Cincinnati and the Lindner Center for Research and Education at The Christ Hospital, Ohio Heart and Vascular Center Inc., Cincinnati, Ohio
Cordis Corp., Warren, New Jersey
Brigham and Women’s Hospital, Boston, Massachusetts
Hamburg University Cardiovascular Center, Hamburg, Germany
^|| Hospital du Sacre’-Coeur de Montreal, Montreal, Canada
^¶ Swiss Cardiovascular Center Bern, Bern, Switzerland
^# Columbia University Medical Center, New York, New York

View larger version (44K): [in a new window]   Figure 1 Late lumen loss by quantitative coronary angiography stratified by stent type, overlapped stent status, and region of interest. BMS = bare-metal stent; SES = sirolimus-eluting stent.

View larger version (22K): [in a new window]   Figure 2 (A) Total myocardial infarction (MI) (both Q- and non–Q-wave) by stent type (bare-metal stents [BMS], n = 238; sirolimus-eluting stent [SES], n = 337) in patients treated with overlapping stents. (B) Incidence of total MI at 30 days by stent type stratified by total implanted stent length. (C) Total MI at 360 days by stent type stratified by total implanted stent length. Solid bars = BMS; open bars = SES.

View larger version (17K): [in a new window]   Figure 3 Target lesion revascularization (TLR) and target vessel revascularization (TVR) through 360 days as well as target vessel failure (TVF) (composite occurrence of death, myocardial infarction, and TLR) stratified by stent type in patients treated with overlapping stents. BMS = bare metal stent; SES = sirolimus-eluting stent.

View larger version (18K): [in a new window]   Figure 4 In-stent binary (>50%) angiographic restenosis (A) and target lesion revascularization (B) stratified by stent type and overlap (vs. single) stent status. *p < 0.0001 for comparisons sirolimus-eluting stent (SES) versus bare-metal stent (BMS) and BMS overlap versus single stent; p = 0.0016 for SES overlap versus single stent. p < 0.0001 for comparisons SES versus BMS; p = 0.0006 BMS overlap versus single stent; p = NS SES overlap versus single stent. Solid bars = BMS; open bars = SES.