Journal Article

Cause of death with bare metal and sirolimus-eluting stents†

David R. Holmes, Jeffrey W. Moses, Joachim Schofer, Marie-Claude Morice, Erick Schampaert and Martin B. Leon

in European Heart Journal

Published on behalf of European Society of Cardiology

Volume 27, issue 23, pages 2815-2822
Published in print December 2006 | ISSN: 0195-668x
Published online November 2006 | e-ISSN: 1522-9645 | DOI: http://dx.doi.org/10.1093/eurheartj/ehl385
Cause of death with bare metal and sirolimus-eluting stents†

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Aims Although drug-eluting stents have assumed a dominant role in interventional cardiology, concern has been raised about the potential for long-term adverse outcomes, including death. The aim of the present study was to compare the incidence and cause of death between patients who received sirolimus-eluting or bare metal stents.

Methods and results An integrated analysis was performed on 1748 patients enrolled in four prospective double-blind trials that randomly assigned patients to receive either a sirolimus-eluting or a bare metal stent for treatment of a single de novo coronary stenosis. During a mean follow-up of 2.6±0.6 years, 64 patients (3.7%) died. Total mortality was 3.2% among 870 bare metal stent patients and 4.1% among 878 sirolimus-eluting stent patients (P=0.37); there was no difference in cardiac mortality (1.4 vs. 1.3%; P=0.55) or causes of death between these two groups. The predominant cause of death was non-cardiac. Cardiac death was most frequently assigned owing to unwitnessed death. Death due to acute myocardial infarction, congestive heart failure, and stent thrombosis occurred infrequently.

Conclusion At a mean follow-up of 2.6 years in percutaneous coronary intervention patients, the predominant cause of death was non-cardiac. There was no significant difference in either the frequency or the cause of death with implantation of either sirolimus-eluting or bare metal stents.

Keywords: Cardiac death; Drug-eluting stents; Follow-up mortality

Journal Article.  5017 words.  Illustrated.

Subjects: Cardiovascular Medicine

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