title: Drug-eluting stents for the treatment of bifurcation lesions: a randomized comparison between paclitaxel and sirolimus stents.
abstract: BACKGROUND
  Drug-eluting stents have been shown to reduce restenosis in many types of lesions. The purpose of this article is to assess the efficacy of sirolimus- and paclitaxel-eluting stents in patients with bifurcation lesions.
  
  
  METHODS
  Between June 2003 and October 2004, 205 patients were enrolled in a prospective randomized trial; 103 patients were assigned to sirolimus stents and 102 patients to paclitaxel stents. All patients were treated by provisional T-stenting.
  
  
  RESULTS
  There were no differences between groups in terms of age, risk factors, clinical condition, location of the bifurcation lesion, or other technical factors. Angiographic data and immediate results were also similar in both groups. Three patients developed inhospital non-Q-wave acute myocardial infarction (2 from the sirolimus group and 1 from the paclitaxel group). Follow-up angiography was obtained in 109 patients (53%). In the sirolimus group, 5 patients developed restenosis (9%): 1 at the main vessel, 2 at the side branch, and 2 in both branches. In contrast, 16 patients from the paclitaxel group had restenosis (29%): 6 at the main vessel, 5 at the side branch, and 5 in both branches. Target lesion revascularization at 24 +/- 5 months post stenting occurred in 4 patients from the sirolimus group (4%) and in 13 from the paclitaxel group (13%) (P < .05). Late loss at the main vessel in the sirolimus group patients was 0.31 +/- 0.59 versus 0.60 +/- 0.77 mm in patients from the paclitaxel group (P < .05).
  
  
  CONCLUSIONS
  Patients with bifurcation lesions treated by sirolimus showed significantly lower rates of late loss, restenosis and target lesion revascularization than patients treated with paclitaxel-eluting stents.
authors.affiliation: Hospital Reina Sofía, University of Córdoba, Córdoba, Spain. grupocorpal@grupocorpal.com
authors.forename: Manuel
authors.initials: M
authors.lastname: Pan
authors.forename: José
authors.initials: J
authors.lastname: Suárez de Lezo
authors.forename: Alfonso
authors.initials: A
authors.lastname: Medina
authors.forename: Miguel
authors.initials: M
authors.lastname: Romero
authors.forename: Antonio
authors.initials: A
authors.lastname: Delgado
authors.forename: José
authors.initials: J
authors.lastname: Segura
authors.forename: Soledad
authors.initials: S
authors.lastname: Ojeda
authors.forename: Francisco
authors.initials: F
authors.lastname: Mazuelos
authors.forename: Enrique
authors.initials: E
authors.lastname: Hernandez
authors.forename: Francisco
authors.initials: F
authors.lastname: Melian
authors.forename: Djordje
authors.initials: D
authors.lastname: Pavlovic
authors.forename: Fátima
authors.initials: F
authors.lastname: Esteban
authors.forename: Juan
authors.initials: J
authors.lastname: Herrador
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy*; D023903:Coronary Restenosis / Q000453:epidemiology / Q000517:prevention & control; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D011446:Prospective Studies; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D019210:Troponin I / Q000097:blood; D018084:Ultrasonography, Interventional
chemical_list: D007166:Immunosuppressive Agents; D019210:Troponin I; D003402:Creatine Kinase; D017239:Paclitaxel; D020123:Sirolimus