Long-term outcomes of drug-eluting stents versus bare-metal stents in saphenous vein graft disease: Results from the Prairie "Real World" Stent Registry
Objectives: This study was designed to compare long‐term clinical outcomes of drug‐eluting stents (DES) versus bare metal stents (BMS) in patients with saphenous vein graft (SVG) disease in the “real world.” Background: The safety and efficacy of DES versus BMS in SVG remains uncertain due to contra...
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| Published in: | Catheterization and cardiovascular interventions Vol. 75; no. 1; pp. 93 - 100 |
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| Main Authors: | , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Hoboken
Wiley Subscription Services, Inc., A Wiley Company
01-01-2010
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Objectives:
This study was designed to compare long‐term clinical outcomes of drug‐eluting stents (DES) versus bare metal stents (BMS) in patients with saphenous vein graft (SVG) disease in the “real world.”
Background:
The safety and efficacy of DES versus BMS in SVG remains uncertain due to contradictory reports of either lower revascularization rates with DES; or clinical equivalence to BMS; or even an excess of clinical events associated with DES use.
Methods:
We identified consecutive patients who underwent stent placement within a de novo SVG lesion between May 1, 2003 and July 31, 2007. Follow‐up was obtained at regular intervals. The Kaplan–Meier method was used to produce actuarial survival estimates. Cox regression analysis was used to predict the risk associated with stent type, and propensity scores were generated to risk‐adjust the results.
Results:
The study group included 379 stent recipients (284 DES; 95 BMS) with 410 stented lesions. BMS were placed more frequently in current smokers, acute myocardial infarctions, larger vessels, and longer lesions. In‐hospital mortality was higher in BMS recipients than in their DES counterparts (3.2% vs. 0, respectively; P = 0.015). At 3 years, there was no significant difference in clinical adverse event rates between DES and BMS recipients, even after risk adjustment.
Conclusions:
Three‐year adverse event rates are similar among patients treated with DES or BMS in SVG lesions. Therefore, while DES are safe, they do not appear to offer an advantage in terms of long‐term graft patency. © 2009 Wiley‐Liss, Inc. |
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| Bibliography: | ark:/67375/WNG-GBT9S5J2-M istex:7C4CF2EFB9CC3DD5EA082F8F828F3922B056D9C8 ArticleID:CCD22194 Conflict of interest: Dr. Goswami discloses consulting income from Cardiva, Boston Scientific, The Medicines Company, and Bristol Myers Squibb. Dr. Mishkel discloses consulting income from Cordis Corp./J&J, Boston Scientific, The Medicines Company, Abbott Vascular, Medtronic, and W.L. Gore & Associates. None of the other authors have any financial or other associations that may pose a conflict of interest. Phone: (217) 788‐0706, Fax: (217) 525‐2799 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 1522-1946 1522-726X |
| DOI: | 10.1002/ccd.22194 |