Abstract | OBJECTIVE: METHODS: From December 2001 through February 2003, 76 patients with 103 de novo lesions treated percutaneously with bare stents received a loading dose of oral rapamycin 6 mg followed by a daily dose of 2 mg during 28 days in phase I (49 arteries in 34 patients) and 2 mg/day plus 180 mg/day of diltiazem in phase II (54 arteries in 42 patients). Rapamycin blood concentrations were measured in all patients. A six month follow up angiogram was performed in 82.5% (85 of 103 arteries). Follow up angiographic binary restenosis (> 50%), target vessel revascularisation, late loss, treatment compliance, and major adverse cardiovascular events were analysed and correlated with rapamycin concentrations. RESULTS:
Rapamycin was well tolerated and only three patients discontinued the treatment for mild side effects. Angiographic restenosis was found in 15% of the arteries with angiographic restudy (13 of 85). The target vessel had been revascularised at follow up in 13.6% of the 103 vessels initially treated (14 of 103) and in 18.4% of the 76 patients (14 of 76). In- stent restenosis in phase I was 19% compared with 6.2% in phase II (p = 0.06). Angiographic in- stent restenosis in lesions of patients with rapamycin blood concentrations > or = 8 ng/ml was 6.2% and with rapamycin concentrations < 8 ng/ml was 22% (p = 0.041). Late loss was also significantly lower when rapamycin concentrations were > or = 8 ng/ml (0.6 mm v 1.1 mm, p = 0.031). A Pearson test showed a linear correlation between follow up late loss and rapamycin blood concentration (r = -0.826, p = 0.008). CONCLUSION:
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Authors | A E Rodríguez, M Rodríguez Alemparte, C F Vigo, C Fernández Pereira, C Llauradó, D Vetcher, A Pocovi, J Ambrose |
Journal | Heart (British Cardiac Society)
(Heart)
Vol. 91
Issue 11
Pg. 1433-7
(Nov 2005)
ISSN: 1468-201X [Electronic] England |
PMID | 15774608
(Publication Type: Journal Article)
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Chemical References |
- Immunosuppressive Agents
- Sirolimus
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Topics |
- Administration, Oral
- Coronary Angiography
- Coronary Restenosis
(blood, prevention & control)
- Female
- Humans
- Immunosuppressive Agents
(administration & dosage, adverse effects, blood)
- Male
- Sirolimus
(administration & dosage, adverse effects, blood)
- Stents
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