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Myocardial Infarction Risk Lower with Sirolimus Stent

Sirolimus-eluting stents outperform paclitaxel-eluting and bare-metal stents

FRIDAY, Sept. 14 (HealthDay News) -- Sirolimus-eluting stents are associated with lower rates of myocardial infarction than paclitaxel-eluting and bare-metal stents, though the overall risk of mortality does not differ among the stent types, according to a meta-analysis in the Sept. 15 issue of The Lancet.

Christoph Stettler, M.D., of the University of Bern in Switzerland, and colleagues conducted a meta-analysis of trials involving sirolimus- and paclitaxel-eluting, and bare-metal stents, including data from 38 trials and 18,023 patients. Further data on outcomes were provided by researchers and stent manufacturers from 29 additional trials.

Mortality was similar for the three types of stents. Sirolimus-eluting stents were associated with a 19 percent lower risk of myocardial infarction than bare-metal stents, and 17 percent lower than paclitaxel-eluting stents. While there was no difference in the overall risk of stent thrombosis for the three groups, the risk of late stent thrombosis with paclitaxel-eluting stents was more than twice that of bare-metal stents and 85 percent higher than sirolimus-eluting stents. Finally, both drug-eluting stents reduced target lesion revascularization more than bare-metal stents, but the effect was more pronounced with sirolimus-eluting stents.

"We conclude, therefore, that sirolimus-eluting stents seem to be clinically better than bare-metal and paclitaxel-eluting stents," the authors write.

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