title: A comparison of angiographic and clinical outcomes after sirolimus-eluting versus paclitaxel-eluting stents for the treatment of in-stent restenosis.
abstract: BACKGROUND
  In-stent restenosis (ISR) remains a challenge for interventional cardiologists. Some data suggest that drug-eluting stents (DES) represent a promising new option for the treatment of patients with ISR. Currently, 2 DES platforms are available [sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES)], but the superiority of either approach for treating ISR has not been convincingly demonstrated. The aim of the present study was to retrospectively compare angiographic and clinical outcomes after treatment of ISR with SES or PES in a series of consecutive patients with ISR.
  
  
  METHODS
  A total of 745 consecutive patients were treated with bare metal stents from April 12, 2004 to December 31, 2004 in our center. Of these, clinically driven target lesion revascularization (TLR) was performed in 54 ISR from 54 patients at 7 months. Of the 54 patients with ISR, 36 received SES and 18 received PES. Follow-up included angiography and assessment of clinical outcome, both performed 7 months after DES implantation.
  
  
  RESULTS
  There were no significant differences in baseline clinical data (including medication usage and lesion characteristics) between the two groups. Except for overlapping of multiple stents, procedural parameters were also similar in both groups. Seven-month angiographic follow-up showed that the binary restenosis rate was higher in patients treated with PES than that in patients treated with SES (in-stent binary restenosis: 27.8% vs 5.6%, P < 0.023; In-segment binary restenosis: 44.4% vs 13.9%, P < 0.014). Major adverse cardiac events (MACE) occurring during hospitalization or during the follow-up period including thrombosis and TLR was similar in both groups (22.2% vs 8.3%, P > 0.05).
  
  
  CONCLUSIONS
  Results from this small sample size, retrospective, single-center study showed that SES might be superior to PES in treating ISR because of lower 7-month restenosis rates (both in-stent and in-segment binary restenosis) with no increased incidence of MACE.
authors.affiliation: Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China. lijnjn@yahoo.com.cn
authors.forename: Jian-jun
authors.initials: JJ
authors.lastname: Li
authors.forename: Bo
authors.initials: B
authors.lastname: Xu
authors.forename: Yue-jin
authors.initials: YJ
authors.lastname: Yang
authors.forename: Wei-hua
authors.initials: WH
authors.lastname: Ma
authors.forename: Ji-lin
authors.initials: JL
authors.lastname: Chen
authors.forename: Shu-bing
authors.initials: SB
authors.lastname: Qiao
authors.forename: Xue-wen
authors.initials: XW
authors.lastname: Qin
authors.forename: Min
authors.initials: M
authors.lastname: Yao
authors.forename: Hai-bo
authors.initials: HB
authors.lastname: Liu
authors.forename: Yong-jian
authors.initials: YJ
authors.lastname: Wu
authors.forename: Jin-qing
authors.initials: JQ
authors.lastname: Yuan
authors.forename: Jue
authors.initials: J
authors.lastname: Chen
authors.forename: Shi-Jie
authors.initials: SJ
authors.lastname: You
authors.forename: Jun
authors.initials: J
authors.lastname: Dai
authors.forename: Ran
authors.initials: R
authors.lastname: Xia
authors.forename: Run-lin
authors.initials: RL
authors.lastname: Gao
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D016503:Drug Delivery Systems; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents
chemical_list: D017239:Paclitaxel; D020123:Sirolimus