title: Sirolimus-eluting stents for treatment of drug-eluting versus bare-metal stents restenosis: 42-month clinical outcomes from a Chinese single center.
abstract: BACKGROUND
  Restenosis of bare-metal stents (BMS) and drug-eluting stents (DES) has been increasingly treated with sirolimus-eluting stents (SES), but the long-term outcomes are unknown.
  
  
  METHODS
  In our study, 388 consecutive patients (144 DES restenosis and 244 BMS restenosis) with 400 lesions (147 DES restenosis and 253 BMS restenosis) treated with SES were included. The rates of target lesion revascularization (TLR) and major adverse cardiac events (MACE) at 42 months were analyzed.
  
  
  RESULTS
  At the mean follow-up of 42 months, the rates of death (3.5% vs. 3.3%, P = 1.000) and myocardial infarction (2.8% vs. 1.2%, P = 0.431) in the DES group and BMS group were comparable. Compared with the BMS group, ischemia-driven TLR occurred with a higher frequency in the DES group (18.8% vs. 10.7%, P = 0.024). This translated into an increased rate of MACE in the DES group (22.2% vs. 14.0%, P = 0.034). Stent thrombosis occurred with a similar frequency in both groups (2.8% vs. 1.6%, P = 0.475). Multivariate analysis showed that DES restenosis (OR = 1.907, 95%CI 1.108 - 3.285, P = 0.020) and smoking (OR = 2.069; 95%CI 1.188 - 3.605; P = 0.010) were independent predictors of MACE.
  
  
  CONCLUSIONS
  Although SES implantation appears to be safe and effective, it was associated with higher TLR recurrence for DES than BMS restenosis.
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Rong-Qiang
authors.initials: RQ
authors.lastname: Yan
authors.forename: Ji-Lin
authors.initials: JL
authors.lastname: Chen
authors.forename: Li-Jian
authors.initials: LJ
authors.lastname: Gao
authors.forename: Yue-Jin
authors.initials: YJ
authors.lastname: Yang
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Li
authors.forename: Shu-Bin
authors.initials: SB
authors.lastname: Qiao
authors.forename: Bo
authors.initials: B
authors.lastname: Xu
authors.forename: Min
authors.initials: M
authors.lastname: Yao
authors.forename: Xue-Wen
authors.initials: XW
authors.lastname: Qin
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: Run-Lin
authors.initials: RL
authors.lastname: Gao
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000627:therapeutic use*; D015607:Stents / Q000009:adverse effects*
chemical_list: D020123:Sirolimus