[Coronary angioplasty in the real world: the RESTEM registry. Outcome of patients treated with sirolimus-eluting stents].
BACKGROUND
RESTEM, a prospective multicenter registry collecting all percutaneous coronary interventions made over 20 months and monitored up to 2 years, had been performed to assess, in the real world, the impact of sirolimus-eluting stents (SES) versus bare metal stents (BMS) on patients' outcomes.


METHODS
The registry includes 5524 consecutive patients treated with BMS (72%), SES (15%), BMS+SES (4%) or other techniques (9%). The combination of death, acute myocardial infarction, unstable angina and revascularization had been chosen as primary endpoint.


RESULTS
The 2-year adjusted results confirm a significant advantage of SES in target vessel revascularization (8.3 vs 13.7%, odds ratio [OR] 0.66), a benefit for overall revascularizations (18.3 vs 25.6%, OR 0.76) without reducing mortality, other clinical events and primary endpoint, therefore denying the benefit on primary endpoint observed at 12 months (18.5 vs 25.0%, OR 0.68 at 1 year and 25.8 vs 32.4%, OR 0.84 at 2 years).


CONCLUSIONS
RESTEM results confirm the SES capacity to reduce target vessel revascularization without decreasing other clinical events, suggest that this advantage is limited to the first 6 months after percutaneous coronary intervention, and show no evidence of excess of deaths, acute myocardial infarction and late thrombosis following SES implantation described in recent meta-analyses.
Campolo
Luigi
L
Gruppo e Fondazione Villa Maria, Lugo di Romagna, RA luigicampolo@alice.it
Pantaleo
Paolo
P
Barattoni
Maria Cristina
MC
Berardo
Arianna
A
Ghetti
Luca
L
Fusco
Danilo
D
D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D023903:Coronary Restenosis / Q000175:diagnosis / Q000000981:diagnostic imaging; D003627:Data Interpretation, Statistical; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D015337:Multicenter Studies as Topic; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology; D011446:Prospective Studies; D012042:Registries; D020123:Sirolimus / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D020123:Sirolimus