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Two‐year outcomes after percutaneous coronary intervention with drug‐eluting stents or bare‐metal stents in elderly patients with coronary artery disease
Author(s) -
Lafont Alexandre,
Sinnaeve Peter R,
Cuisset Thomas,
Cook Stéphane,
Sideris Giorgios,
Kedev Sasko,
Carrie Didier,
Hovasse Thomas,
Garot Philippe,
El Mahmoud Rami,
Spaulding Christian,
Helft Gérard,
Diaz Fernandez José F,
Brugaletta Salvatore,
PinarBermudez Eduardo,
Ferre Josepa Mauri,
Commeau Philippe,
Teiger Emmanuel,
Bogaerts Kris,
Sabate Manel,
Morice Marie Claude,
Varenne Olivier
Publication year - 2021
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.29159
Subject(s) - medicine , percutaneous coronary intervention , conventional pci , myocardial infarction , stroke (engine) , coronary artery disease , stent , cardiology , clinical endpoint , population , drug eluting stent , revascularization , surgery , randomized controlled trial , environmental health , engineering , mechanical engineering
Objectives Report the results at 2 years of the patients included in the SENIOR trial. Background Patients above 75 years of age represent a fast‐growing population in the cathlab. In the SENIOR trial, patients treated by percutaneous coronary intervention (PCI) with drug eluting stent (DES) and a short duration of P2Y12 inhibitor (1 and 6 months for stable and unstable coronary syndromes, respectively) compared with bare metal stents (BMS) was associated with a 29% reduction in the rate of all‐cause mortality, myocardial infarction (MI), stroke, and ischaemia‐driven target lesion revascularization (ID‐TLR) at 1 year. The results at 2 years are reported here. Methods and Results We randomly assigned 1,200 patients (596[50%] to the DES group and 604[50%] to the BMS group). At 2 years, the composite endpoint of all‐cause mortality, MI, stroke and ID‐TLR had occurred in 116 (20%) patients in the DES group and 131 (22%) patients in the BMS group (RR 0.90 [95%CI 0.72–1.13], p = .37). IDTLR occurred in 14 (2%) patients in the DES group and 41 (7%) patients in the BMS group (RR 0.35 [95%CI 0.16–0.60], p = .0002). Major bleedings (BARC 3–5) occurred in 27(5%) patients in both groups (RR 1.00, [95%CI 0.58–1.75], p = .99). Stent thrombosis rates were low and similar between DES and BMS (0.8 vs 1.3%, (RR 0.52 [95%CI 0.01–1.95], p = .27). Conclusion Among elderly PCI patients, a strategy combining a DES together with a short duration of DAPT is associated with a reduction in revascularization up to 2 years compared with BMS with very few late events and without any increased in bleeding complications or stent thrombosis.