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Sustained risk of stent thrombosis and restenosis in first generation drug‐eluting Stents after One Decade of Follow‐up: A Report from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)
Author(s) -
Völz Sebastian,
Angerås Oskar,
Odenstedt Jacob,
Ioanes Dan,
Haraldsson Inger,
Dworeck Christian,
Redfors Björn,
Råmunddal Truls,
Albertsson Per,
Petursson Petur,
Omerovic Elmir
Publication year - 2018
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.27655
Subject(s) - medicine , restenosis , cardiology , proportional hazards model , stent , angioplasty , drug eluting stent , angina , clinical endpoint , surgery , randomized controlled trial , myocardial infarction
Aims Long‐term comparisons between Drug‐eluting stent and bare metal stent are not well‐studied. The aim of this study was to compare two stents that were previously frequently used in regard to long‐term risk of restenosis and stent thrombosis (ST). Methods and results We used data from the SCAAR registry. Consecutive procedures performed between 2004 and 2014 for stable angina, UA/NSTEMI and STEMI were included. We compared two different stents: Cordis Cypher Select (C‐CS), and Boston Scientific Liberte (BS‐L), modeling data with multilevel Cox proportional‐hazards regression. The primary endpoint was time to first occurrence of either ST or restenosis. During the study period 2210 C‐CS and 6941 B‐SL were implanted in 5,314 patients. Mean follow‐up time was 2,288 days for C‐CS and 2,297 days for BS‐L. Treatment with C‐CS was associated with lower risk for restenosis or ST up to one year from index procedure (HR 0.41; 95% CI 0.32‐0.52; P < .001). However, after one year of follow‐up, risk was substantially higher in C‐CS (HR 2.81; 95% CI 2.25‐3.50; P < .001). Conclusion Treatment with C‐CS was not associated with better outcome than BS‐L. Continuation of restenosis and ST long after the index procedure with C‐CS present a major concern for patient safety.