Assessment of sirolimus-eluting coronary stent implantation with aspirin plus low dose ticlopidine administration: one year results from CYPHER Stent Japan Post-Marketing Surveillance Registry (J-PMS)

Circ J. 2009 Jun;73(6):1038-44. doi: 10.1253/circj.cj-08-0732. Epub 2009 Apr 14.

Abstract

Background: Clinical data of sirolimus-eluting stent (SES) implantation are under investigation in Japan.

Methods and results: The CYPHER stent Japan Post-Marketing Surveillance Registry (J-PMS) was conducted at 50 medical centers to assess the results of SES in daily clinical practice exclusively under aspirin plus low dose ticlopidine (200 mg/day). A total of 2,459 lesions in 2,054 patients were treated with 3,285 SES. The mean age was 67.1 +/-10.1 years, 75.6% were men and 43.3% were diabetics. Intravascular ultrasound was used in 77.2%. The 8-month angiographic and 1-year clinical follow-up data were available in 85.4% and 96.8%, respectively. Quantitative coronary angiography showed the reference vessel diameter and percentage diameter stenosis at baseline were 2.47 +/-0.58 mm and 72.0 +/-16.1%. The 8-month late loss was 0.20 +/-0.50 mm. The major adverse cardiovascular events at 1 year was 7.3%; cardiac death: 1.1%, myocardial infarction (MI): 1.2%, and target lesion revascularization (TLR): 4.2%. The rates of definite and probable stent thrombosis at 1 year were 0.30% and 0.10%, respectively. Hemodialysis was the strongest predictor of death/MI or TLR.

Conclusions: J-PMS showed the effectiveness of SES implantation under aspirin plus low dose ticlopidine administration at 1 year, although further studies are necessary to demonstrate the safety.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aspirin / therapeutic use*
  • Combined Modality Therapy
  • Coronary Angiography
  • Coronary Thrombosis / diagnostic imaging
  • Coronary Thrombosis / pathology
  • Coronary Thrombosis / prevention & control*
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / pathology
  • Dose-Response Relationship, Drug
  • Drug-Eluting Stents*
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors / therapeutic use
  • Product Surveillance, Postmarketing*
  • Registries*
  • Sirolimus*
  • Ticlopidine / therapeutic use*
  • Treatment Outcome
  • Ultrasonography, Interventional

Substances

  • Platelet Aggregation Inhibitors
  • Ticlopidine
  • Aspirin
  • Sirolimus