Five-year clinical outcome after primary stenting of totally occluded native coronary arteries: a randomised comparison of bare metal stent implantation with sirolimus-eluting stent implantation for the treatment of total coronary occlusions (PRISON II study).

Abstract

AIMS:

The aim of this study was to examine the five-year clinical outcome in patients enrolled in the Primary Stenting of Totally Occluded Native Coronary Arteries II (PRISON II) study.

METHODS AND RESULTS:

Patients with totally occluded coronary arteries were randomised to either sirolimus-eluting stent (SES, n=100) or bare metal stent (BMS, n=100) implantation. At five years, patients in the SES group had significantly lower rates of target lesion revascularisation (12% vs. 30%, p=0.001), target vessel revascularisation (17% vs. 34%, p=0.009) and major adverse cardiac events (12% vs. 36%, p<0.001). There were no significant differences in death and myocardial infarction. Eight (8%) cases of stent thrombosis (seven definite and one probable; one early, one late, and six very late) were noticed in the SES group versus three cases (3%, one definite and two possible; all very late) in the BMS group (p=0.21).

CONCLUSIONS:

The results of the present study show that the documented superior short-term angiographic and clinical results of SES in patients with total coronary occlusions are maintained during long-term 5-year follow-up as compared with BMS. On the other hand, there is a trend to a higher stent thrombosis rate in the SES group.

• Authors: Ben J L Van den Branden, Braim M Rahel, Gerrit J Laarman, Ton Slagboom, Johannes C Kelder, Juriën M Ten Berg, Maarten J Suttorp
• Journal: EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology (EuroIntervention) Vol. 7 Issue 10 Pg. 1189-96 (Feb 2012) ISSN: 1969-6213 [Electronic] France
• PMID: 22030323 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Metals
• Sirolimus

Topics

• Aged
• Angioplasty, Balloon, Coronary (instrumentation, methods)
• Cohort Studies
• Coronary Occlusion (mortality, therapy)
• Coronary Restenosis (epidemiology)
• Drug-Eluting Stents (adverse effects)
• Female
• Follow-Up Studies
• Humans
• Incidence
• Longitudinal Studies
• Male
• Metals
• Middle Aged
• Myocardial Infarction (epidemiology)
• Sirolimus
• Stents (adverse effects)
• Survival Rate
• Thrombosis (epidemiology, etiology)
• Treatment Outcome