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Early experience with everolimus-eluting stents in real-world patients: one-year clinical follow-up

BACKGROUND: Everolimus-eluting stents have proved to be safe and effective in the treatment of low-risk, selected patients, from randomized trials. Nonetheless, studies assessing their impact on more complex real-world patients are rare. METHOD: We prospectively evaluated 193 patients treated with everolimus-eluting stents alone. The only exclusion criteria were: in-stent restenosis of another drug-eluting stent, percutaneous coronary intervention of a saphenous vein graft and acute myocardial infarction with ST segment elevation. The primary endpoint was the incidence of major adverse cardiac events (MACE), defined as the composite of cardiac death, myocardial infarction and target vessel revascularization. RESULTS: Mean age was 60.6 ± 11.8 years. Half of the patients were women and 36.8% were diabetics. Multivessel disease was found in 61.6% of the patients. Patients had 1.8 ± 0.66 lesion treated in 1.73 ± 0.9 vessel, with a mean of 2.27 ± 0.9 stents per patient. The majority (70.6%) of the lesions were type B2/C, true bifurcations were treated in 37.3% of the cases and moderate to severe calcifications were observed in 17.4% of the lesions. The 1-year MACE rate was 6.7%, mainly due to the occurrence of in-hospital events. There was only one (0.5%) case of probable subacute stent thrombosis. No cases of late stent thrombosis were observed. CONCLUSIONS: The present analysis suggests that the use of everolimus eluting stents is safe and effective in the treatment of complex patients from the daily clinical practice, with low major adverse cardiac events rate in the 1-year follow-up. Longer follow-up with a larger number of patients is required to confirm these promising results.

Coronary disease; Coronary restenosis; Drug-eluting stents; Paclitaxel; Sirolimus; Thrombosis; Follow-up studies; Treatment outcome


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