Treatment of left anterior descending coronary artery disease with sirolimus-eluting stents

Revascularization strategies often hinge on the presence and degree of left anterior descending coronary artery (LAD) stenosis. A decision for bypass surgery is often based on the durability of surgical LAD revascularization compared with percutaneous approaches. By decreasing restenosis, drug-eluti...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2004-07, Vol.110 (4), p.374-379
Main Authors: Sawhney, Neil, Moses, Jeffrey W, Leon, Martin B, Kuntz, Richard E, Popma, Jeffrey J, Bachinsky, William, Bass, Theodore, DeMaio, Samuel, Fry, Edward, Holmes, Jr, David R, Teirstein, Paul S
Format: Article
Language:English
Subjects:
Aged
Angioplasty, Balloon, Coronary
Anticoagulants - therapeutic use
Aspirin - therapeutic use
Cohort Studies
Coronary Angiography
Coronary Restenosis - diagnostic imaging
Coronary Restenosis - prevention & control
Coronary Stenosis - complications
Coronary Stenosis - drug therapy
Coronary Stenosis - therapy
Double-Blind Method
Drug Implants
Female
Humans
Life Tables
Male
Middle Aged
Myocardial Infarction - etiology
Myocardial Infarction - mortality
Premedication
Sirolimus - administration & dosage
Sirolimus - therapeutic use
Stents
Survival Analysis
Ticlopidine - analogs & derivatives
Ticlopidine - therapeutic use
Treatment Outcome
Ultrasonography
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Summary:Revascularization strategies often hinge on the presence and degree of left anterior descending coronary artery (LAD) stenosis. A decision for bypass surgery is often based on the durability of surgical LAD revascularization compared with percutaneous approaches. By decreasing restenosis, drug-eluting stents may have reduced the "reintervention gap" between surgery and percutaneous intervention, making the percutaneous route preferable. Of the 1101 patients in the SIRIUS trial, 459 with an LAD stenosis were randomized to percutaneous intervention with either sirolimus-eluting or bare-metal stents. Baseline demographic, clinical, and angiographic data were obtained. Patients had 1-year clinical and 8-month angiographic follow-up. Baseline characteristics were similar in both groups. The majority of lesions were tubular type B lesions (69.7%) with a mean diameter of 2.73 mm and a mean length of 14.0 mm. The binary in-stent restenosis rate was 2% for the sirolimus stent group and 41.6% for the bare-metal arm (relative risk, 0.05; 95% CI, 0.02 to 0.1; P
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.0000136580.34604.B8