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February 22, 2006

Wish List and REALITYChoice of Stents and End Points for Treatment of De Novo Coronary Artery Lesions

Author Affiliations

Author Affiliation: Department of Medicine, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio.

JAMA. 2006;295(8):937-938. doi:10.1001/jama.295.8.937

In this issue of JAMA, Morice and colleagues1 present the results of the much anticipated REALITY trial, a prospective, randomized, nonblinded (operator) comparison of the sirolimus-eluting stent and the paclitaxel-eluting stent in patients with de novo coronary artery disease. Among the 1353 patients enrolled, nearly a third had diabetes mellitus, 40% had a previous infarction, and one quarter presented with unstable angina. The study protocol called for the randomization of 1 or 2 lesions (38% of patients) in (surprisingly) relatively small vessels (mean, 2.4 mm) to paclitaxel-eluting stent or sirolimus-eluting stent with independently conducted angiographic and clinical follow-up at 8 and 12 months, respectively. Of note, more than 90% of the patients returned for angiographic follow-up, an unusually high rate for this kind of trial.

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