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Long term follow‐up of drug eluting versus bare metal stents in the treatment of saphenous vein graft lesions
Author(s) -
Ybarra Luiz F.,
Ribeiro Henrique B.,
Pozetti Antonio H.,
Campos Carlos A.,
Esper Rodrigo B.,
Lemos Pedro A.,
Lopes Augusto C.,
KalilFilho Roberto,
Ellis Stephen G.,
Ribeiro Expedito E.
Publication year - 2013
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.24781
Subject(s) - medicine , mace , hazard ratio , myocardial infarction , cardiology , stent , clinical endpoint , bare metal stent , drug eluting stent , confidence interval , revascularization , saphenous vein graft , surgery , percutaneous coronary intervention , randomized controlled trial , artery
Introduction The safety and effectiveness of drug‐eluting stent (DES) compared with bare metal stents (BMS) for the treatment of saphenous vein graft (SVG) disease is controversial, especially because of the lack of long‐term follow‐up. The aim of this study was to address the late outcome of DES versus BMS for the treatment of SVG lesions. Methods A matched, case‐control study included 82 patients in each group. Patients groups were matched by gender, age, clinical presentation, and diabetes. The primary study end point was occurrence of major adverse cardiovascular events (MACE). Secondary end points included death, cardiac death, myocardial infarction (MI), and target vessel revascularization (TVR). Results Clinical and angiographic characteristics were similar between the groups. At 6 months, TVR (hazard ratio [HR] 6.12, 95% confidence interval [CI] 1.39 to 26.93, P = 0.05), and MACE (HR 2.54, 95% CI 1.08 to 5.98, P = 0.04) were higher in the BMS group. At 4 years the risks of MI ( P = 0.21), TVR ( P = 0.99), and MACE ( P = 0.21) were similar between both groups. However, the rates of death (HR 2.74, 95% CI 1.11 to 6.74, P = 0.04) and cardiac death (HR 4.26, 95% CI 1.59 to 11.35, P = 0.01) were significantly higher in the BMS group. Conclusions These results suggest that the use of DES compared with BMS in the treatment of SVG lesions reduces TVR and MACE at 6 months of follow‐up, a benefit that was lost over the next 3–4 years. © 2012 Wiley Periodicals, Inc.