[Comparing moderately late results of the application of stents coated with a medicinal antiproliferative agent for the treatment of patients with various forms of coronary heart disease: their efficacy and safety].

Abstract

Extensive application of stents coated with a medicinal antiproliferative agent in clinical practice significantly improved late results of endovascular treatment of patients with various forms of coronary heart disease (CHD). The largest clinical experience is gained with the use of sirolimus- and paclitaxel-coated stents (Cypher, J&J; Cordis, and Taxus, Boston Scientific). However recent publications suggest a rather high frequency of late thrombosis after implantation of such stents. The aim of this work was to estimate their efficacy and safety during the 6-8 month follow-up in 712 patients with various forms of CHD to whom 910 sirolimus- and paclitaxel-coated stents were implanted. The immediate positive angiographic result was documented in 98.8% of the cases in group 1 (n=514, 667 Cypher stents) and 96,7% in group 2 (n=198, 243 Taxus stents). Acute thrombosis was documented in 1 patient of each group (p > 0.5). The frequency of restenosis was 2.9 and 3.1% in groups 1 and 2 respectively (p > 0.5). Late thrombosis within 1 year after implantation occurred in 0.4 and 1% of the patients respectively (p > 0.5). Late thrombosis is supposed to be due to a variety of factors, viz. withdrawal of antithrombotic therapy, incomplete stent opening, the use of non-absorbable polymer; suppression of epithelization, etc. All patients undergoing steent implantation are in need of antiaggregation therapy with acetylsalicylic acid and clopidogrel till the cause of late thrombosis is clarified.

• Authors: V V Mazurova, O E Sukhorukov, O V Zakharova
• Journal: Klinicheskaia meditsina (Klin Med (Mosk)) Vol. 90 Issue 6 Pg. 30-5 ( 2012) ISSN: 0023-2149 [Print] Russia (Federation)
• PMID: 22997717 (Publication Type: Comparative Study, English Abstract, Journal Article)

Chemical References

• Paclitaxel
• Sirolimus

Topics

• Adult
• Cell Proliferation (drug effects)
• Coronary Angiography
• Coronary Disease (drug therapy, physiopathology, surgery, therapy)
• Coronary Restenosis (etiology)
• Drug-Eluting Stents (adverse effects)
• Endovascular Procedures (adverse effects)
• Follow-Up Studies
• Humans
• Paclitaxel (administration & dosage)
• Sirolimus (administration & dosage)
• Thrombosis (etiology)
• Time Factors
• Treatment Outcome