{"id":38918,"date":"2013-09-20T09:00:11","date_gmt":"2013-09-20T13:00:11","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=voices&p=38918"},"modified":"2013-09-17T15:14:32","modified_gmt":"2013-09-17T19:14:32","slug":"my-stent-is-better-than-your-stent","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2013\/09\/20\/my-stent-is-better-than-your-stent\/","title":{"rendered":"My Stent Is Better Than Your Stent"},"content":{"rendered":"

In a meta-analysis<\/a> of the final 3-year results of the international SPIRIT (Clinical Evaluation of the Xience V Everolimus Eluting Coronary Stent System in the Treatment of Patients With De Novo Native Coronary Artery Lesions) II, III, and IV clinical trials, coronary implantation of the everolimus-eluting stent (EES) was superior to\u00a0 the use of the paclitaxel-eluting stent (PES)<\/i><\/b>, with \u00a0reduced rates of all-cause death, myocardial infarction (MI), ischemia-driven target-lesion revascularization (TLR), stent thrombosis, and target-lesion failure (a composite of cardiac death, target-vessel MI, and ischemia-driven TLR).<\/p>\n

 <\/p>\n\n\n\n\n\n\n\n\n
<\/td>\n\n

EES (%)<\/h3>\n

(n=3350)<\/h3>\n<\/td>\n

\n

PES (%)<\/h3>\n

(n=1639)<\/h3>\n<\/td>\n

\n

Hazard ratio<\/h3>\n<\/td>\n

\n

P value<\/h3>\n<\/td>\n<\/tr>\n

\n

Mortality<\/h3>\n<\/td>\n

\n

3.2<\/h3>\n<\/td>\n

\n

5.1<\/h3>\n<\/td>\n

\n

0.65<\/h3>\n<\/td>\n

\n

0.003<\/h3>\n<\/td>\n<\/tr>\n

\n

MI<\/h3>\n<\/td>\n

\n

3.2<\/h3>\n<\/td>\n

\n

5.1<\/h3>\n<\/td>\n

\n

0.64<\/h3>\n<\/td>\n

\n

0.002<\/h3>\n<\/td>\n<\/tr>\n

\n

Ischemia-driven TLR<\/h3>\n<\/td>\n

\n

6.0<\/h3>\n<\/td>\n

\n

8.2<\/h3>\n<\/td>\n

\n

0.72<\/h3>\n<\/td>\n

\n

0.004<\/h3>\n<\/td>\n<\/tr>\n

\n

Stent thrombosis<\/h3>\n<\/td>\n

\n

0.7<\/h3>\n<\/td>\n

\n

1.7<\/h3>\n<\/td>\n

\n

0.45<\/h3>\n<\/td>\n

\n

0.003<\/h3>\n<\/td>\n<\/tr>\n

\n

Target-lesion failure<\/h3>\n<\/td>\n

\n

8.9<\/h3>\n<\/td>\n

\n

12.5<\/h3>\n<\/td>\n

\n

0.71<\/h3>\n<\/td>\n

\n

0.0002<\/h3>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

1. With all the different stents available, how do you decide which stent(s) to use?<\/strong><\/p>\n

2. What factors affect your decision (i.e., product, patient, personal, cath lab stock, etc) ?<\/strong><\/p>\n

3. To what extent is your choice evidence-based? If 0% is personal opinion and 100% is entirely data-driven, how \u201cevidence-based\u201d is your choice?<\/strong><\/p>\n

4. Each stent manufacturer extols the virtues of its own product. Where do you get your information regarding stent superiority?<\/strong><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Interventionalists have many choices when it comes to coronary stents. Rick Lange and David Hillis want to know: “How do you decide which stent to use?”<\/p>\n","protected":false},"author":214,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[777,1982,301,1981,437],"class_list":["post-38918","post","type-post","status-publish","format-standard","hentry","category-interventional-cardiology","tag-everolimus-eluting-stent","tag-paclitaxel-eluting-stent","tag-pci","tag-spirit-trials","tag-stents"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/38918","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/214"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=38918"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/38918\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=38918"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=38918"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=38918"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}