title: Safety and efficacy of everolimus-eluting stents for bare-metal in-stent restenosis.
abstract: OBJECTIVE
  The aim of this study was to compare the safety and efficacy of the everolimus-eluting stents (EES) with the paclitaxel-eluting stent (PES) and sirolimus-eluting stent (SES) for the treatment of bare-metal in-stent restenosis.
  
  
  BACKGROUND
  The optimal treatment for bare-metal in-stent restenosis remains controversial.
  
  
  METHODS
  The study cohort comprised 322 consecutive patients (543 lesions) who presented with bare-metal in-stent restenosis to our institution and underwent coronary artery stent implantation with EES (114 patients; 181 lesions), PES (65 patients; 116 lesions) and SES (143 patients; 246 lesions). The analyzed clinical parameters were the 1-year rates of death, Q-wave myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), definite stent thrombosis (ST) and major adverse cardiac events (MACE) defined as the composite of death, MI, or TLR at 1-year.
  
  
  RESULTS
  The three groups were well matched for the conventional risk factors except for age and chronic kidney disease. The 1-year analyzed clinical parameters were similar in the three groups: death (EES=3.5%, PES=4.6%, SES=4.2%; p=0.94), MI (EES=3.5%, PES=6.3%, SES=2.1%; p=0.31), TLR (EES=9.8%, PES=9.5%, SES=5.7%; p=0.42), TVR (EES=14.3%, PES=11.1%, SES=11.3%; p=0.74), definite ST (EES=0.9%, PES=3.1%, SES=3.5%; p=0.38) and MACE (EES=14.0%, PES=15.4%, SES=10.5%; p=0.54). Male gender (hazard ratio=0.47; 95% confidence interval=0.25-0.88) and number of treated lesions (hazard ratio=1.47; 95% confidence interval=1.06-2.05) were found to be independent predictors of MACE.
  
  
  CONCLUSIONS
  The results of the present study indicate that EES may provide similar safety and efficacy as first generation DES for the treatment of patients presenting with bare-metal in-stent restenosis.
authors.affiliation: Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Ota
authors.affiliation: University of Surrey, Guildford Road, Surrey, GU2-7XH, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Mahmoudi
authors.affiliation: Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Torguson
authors.affiliation: Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Lowell F
authors.initials: LF
authors.lastname: Satler
authors.affiliation: Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: William O
authors.initials: WO
authors.lastname: Suddath
authors.affiliation: Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Augusto D
authors.initials: AD
authors.lastname: Pichard
authors.affiliation: Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA. Electronic address: ron.waksman@medstar.net.
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000628:therapy*; D023903:Coronary Restenosis / Q000628:therapy*; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000379:methods; D012307:Risk Factors; D020123:Sirolimus / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000068338:Everolimus; D020123:Sirolimus
keywords: Bare-metal in-stent restenosis; Everolimus-eluting stent; Target lesion revascularization