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Early beneficial effects of drug‐eluting stents in vein grafts wane during long term follow‐up
Author(s) -
Pasceri Vincenzo,
Tarsia Giandomenico,
Niccoli Giampaolo,
Viceconte Nicola,
Porto Italo,
Leone Antonio Maria,
Trani Carlo,
Speciale Giulio,
LIsanti Pasquale
Publication year - 2012
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.23468
Subject(s) - medicine , mace , conventional pci , percutaneous coronary intervention , myocardial infarction , incidence (geometry) , stent , drug eluting stent , cardiology , surgery , physics , optics
Objectives The aim of the study was to compare outcomes of drug‐eluting stents (DES) versus bare‐metal stents (BMS) in saphenous vein graft (SVG) interventions in a case–control study with a long‐term follow‐up. Background Safety and efficacy of DES in SVG interventions are still controversial. Methods We performed a multicenter registry assessing clinical outcomes with DES vs. BMS. We included 311 patients (239 men, age 68 ± 8 years) who underwent percutaneous coronary interventions (PCI) of SVG lesions with DES ( n = 138) or BMS ( n = 173) with a 2‐year follow‐up. Results The two groups were similar for age, sex, main risk factors, incidence of diabetes, use of IIb/IIIa antagonists, use of aspiration devices or filters, number of stents, and total stent length. Overall, at 9 months follow‐up incidence of major adverse cardiac events (MACE) and target vessel revascularization (TVR) were significantly lower in the DES group compared with the BMS group (10.9% vs. 22.0%, P = 0.014 and 8.7% vs. 19.1% in DES and BMS respectively, P = 0.015), while there was no significant difference in incidence of myocardial infarction (5.1% vs. 5.2%, P = 0.96) or death (2.2% vs. 4%, respectively, P = 0.54). However, at 24‐month follow‐up incidence of MACE was 29.7% in the DES group and 37.0% in BMS group ( P = 0.29); incidence of TVR (23.2% vs. 28.9% P = 0.39), myocardial infarction (9.4% vs. 9.2%), death (7.2% vs. 6.9%) were also similar in the two groups. Conclusions Although DES appear safe, our findings suggest that the early benefit of DES in SVG may rapidly wane during long‐term follow‐up. © 2012 Wiley Periodicals, Inc.