Early beneficial effects of drug‐eluting stents in vein grafts wane during long term follow‐up

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.