Impact of drug-eluting stents on distal vessels.
Circ Cardiovasc Interv
; 5(2): 211-9, 2012 Apr.
Article
em En
| MEDLINE
| ID: mdl-22496083
ABSTRACT
BACKGROUND:
Previous studies have not addressed vessel response >5 mm distal to the stent edge. Therefore, we investigated the impact of paclitaxel-eluting stents (PES) versus bare metal stents (BMS) on distal vessels in the serial intravascular ultrasound substudies of TAXUS IV, V, and VI. METHODS ANDRESULTS:
TAXUS IV, V, and VI were double-blind, randomized, multicenter, controlled trials comparing PES with BMS. In their intravascular ultrasound substudies, 103 patients (54 BMS, 49 PES) had intravascular ultrasound data ≥10 mm distal to the stent both postprocedure and at 9 months follow-up. Baseline characteristics were similar between the 2 groups. Multilevel modeling was used to account for the variation between patients and within patients among distal segments. Effect of stent type, time, and their interaction was tested using a mixed effect model controlling for distal segments. Postprocedure lumen and vessel were not significantly different between PES versus BMS; however, lumen (P=0.006) and vessel (P=0.0001) were significantly reduced for BMS at 9-month follow-up but not for PES. Conversely, there was a significant plaque increase from postprocedure to 9-month follow-up for PES (P=0.0008) but not for BMS. These vessel responses were statistically consistent among 0- to 5-mm versus 5- to 10-mm versus 10- to 15-mm segments distal to the stent in both groups.CONCLUSIONS:
PES use was associated with plaque increase from baseline to 9-month follow-up >5 mm distal to the stent along with positive remodeling, whereas BMS use was associated with negative remodeling and no plaque increase. These vessel responses were consistent in 5-mm long subsegments 0 to 5 mm versus 5 to 10 mm versus 10 to 15 mm distal to the stent. CLINICAL TRIAL REGISTRATION URL HTTP//WWW.CLINICALTRIAL.GOV. Unique identifiers TAXUS IV NCT00292474; TAXUS V NCT00301522; TAXUS VI NCT00297804.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Doença da Artéria Coronariana
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Paclitaxel
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Implante de Prótese Vascular
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Oclusão Coronária
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Stents Farmacológicos
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article