Sirolimus stents safe and effective for patients with restenosis

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NEW YORK (Reuters Health), Aug 1 - Sirolimus-eluting stent implantation appears to be safe and effective in restenosis patients originally treated with bare metal stents, Italian researchers report.

Dr. Francesco Liistro of San Donato Hospital, Arezzo, and colleagues evaluated the success of this approach in 244 unselected patients with first-time in-stent restenosis in a native coronary artery or saphenous vein graft.

The sirolimus stents were successfully implanted in all lesions, researchers report in the July 18th issue of the Journal of the American College of Cardiology.

At nine-month follow-up, four patients (1.6%) had died and four had a myocardial infarction. Ischemia-driven target vessel revascularization was seen in 12 patients (4.9%).

Diabetes and non-ST-segment elevation acute coronary syndrome at presentation were independent predictors of revascularization and major adverse cardiac events. These patients also had a significantly greater incidence of restenosis.

In the 150 patients who completed follow-up angiography, restenosis was seen in 13 (8.7%). Lesion length was an angiographic independent predictor of restenosis (odds ratio, 1.16). Independent clinical predictors of restenosis were diabetes (odds ratio, 3.21) and non-ST-segment elevation acute coronary syndrome (odds ratio, 2.89).

The researchers suggest further evaluation of sirolimus-eluting stent implantation for restenosis in diabetic patients and those with acute coronary syndromes, but, in general, the procedure appears to be safe and effective.

Last Updated: 2006-07-31 13:22:26 -0400 (Reuters Health)

J Am Coll Cardiol 2006;48:270-275.

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