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Medline ® Abstract for Reference 72

of 'Use of intracoronary stents for specific coronary lesions'

72
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Twenty-four months clinical outcomes of sirolimus-eluting stents for the treatment of small coronary arteries: the long-term SES-SMART clinical study.
AU
Menozzi A, Solinas E, Ortolani P, Repetto A, Saia F, Piovaccari G, Manari A, Magagnini E, Vignali L, Bonizzoni E, Merlini PA, Cavallini C, Ardissino D, SES-SMART Investigators
SO
Eur Heart J. 2009;30(17):2095. Epub 2009 Jun 9.
 
AIMS: It has been demonstrated that, in comparison with bare-metal stents (BMS), sirolimus-eluting stents (SES) reduce restenosis after the percutaneous revascularization of small coronary arteries, but the long-term clinical outcomes of this treatment have not yet been investigated.
METHODS AND RESULTS: The long-term SES-SMART clinical study was a multicentre, prospective, randomized, single-blind study of 257 patients receiving a SES or BMS in a small coronary artery, who were evaluated at discharge, 30 days, 8 and 24 months after stenting. The clinical endpoint of the study was a 24 months composite of major adverse cardiac and cerebrovascular events, which included death, non-fatal myocardial infarction, ischaemia-driven target lesion revascularization (TLR), and cerebrovascular accident. The 24 months follow-up was completed by 254 patients (98.8%). The use of SES was associated with a significantly lower incidence of the clinical endpoint (12.6% vs. 33.1%; HR 0.30, 95% CI: 0.17-0.55; P<0.0001), which was not only due to a reduction in TLR (7.9% vs. 29.9%; HR 0.30, 95% CI: 0.16-0.59; P<0.0001), but also to a reduction in myocardial infarction (1.6% vs. 10.2%; HR 0.09, 95% CI: 0.01-0.66; P = 0.018).
CONCLUSION: In comparison with BMS, the use of SES in the percutaneous revascularization of small coronary arteries is associated with improved clinical outcomes after 2 years follow-up.
AD
UnitàOperativa di Cardiologia, Dipartimento Cardio-Polmonare, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy. almenozzi@ao.pr.it
PMID