Comparison of long-term outcomes of drug-eluting stents and bare metal stents for saphenous vein graft stenosis
| Autor: | Brett M. Wertman, Niraj Doctor, James Mirocha, Pavel Goykhman, Stanley Chou, Jesse Naghi, Ryan P. Morrissey, James S. Forrester, Raj Makkar, Tarun Chakravarty |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Constriction Pathologic Kaplan-Meier Estimate Revascularization Coronary Angiography Prosthesis Design Risk Assessment Disease-Free Survival Predictive Value of Tests Risk Factors Internal medicine Angioplasty medicine Humans Radiology Nuclear Medicine and imaging Saphenous Vein Myocardial infarction Angioplasty Balloon Coronary Coronary Artery Bypass Aged Proportional Hazards Models Retrospective Studies Aged 80 and over Proportional hazards model business.industry Hazard ratio Graft Occlusion Vascular Stent Drug-Eluting Stents General Medicine medicine.disease Los Angeles Surgery Stenosis Treatment Outcome Metals Predictive value of tests Cardiology Female Stents Cardiology and Cardiovascular Medicine business |
| Zdroj: | Catheterization and cardiovascular interventions : official journal of the Society for Cardiac AngiographyInterventions. 79(6) |
| ISSN: | 1522-726X |
| Popis: | Objective: Our aim was to compare the long-term outcomes between drug-eluting stents and bare-metal stents for saphenous vein graft stenosis. Background: The ideal type of stent to treat saphenous vein graft stenosis has not been clearly established. Short-term randomized controlled trial results comparing drug-eluting stents with bare-metal stents for saphenous vein graft stenosis are conflicting, intermediate-term retrospective studies and meta-analyses at two years suggest no difference in outcomes, and there are no long term follow-up studies. The need for long term follow-up data has become emerged with concern over late stent thrombosis. Methods: 246 saphenous vein graft patients undergoing stenting from August 2002–December 2008 were studied. Overall survival and event-free survival were compared by Kaplan-Meier method. Hazard ratios (HR) were calculated by Cox-proportional hazards models. Results: We treated 133 patients with DES (median follow-up four years) and 113 patients with BMS (median follow-up four years) for SVG stenosis. Overall survival (77.0% ± 3.9% vs. 70.6% ± 4.6%, log-rank P = 0.60) and MACE-free survival (57.5% ± 4.6% vs. 56.8% ± 4.9, log-rank P = 0.70) were not significantly different between the DES and BMS groups. Although BMS was associated with increased risk of target lesion revascularization (TLR) (freedom from TLR 85.2% ± 3.5% vs. 90.0% ± 3.0%, HR 2.07, 95% CI 0.97–4.42, log-rank P = 0.05), there was no significant difference in the freedom from myocardial infarction (86.7% ± 3.3% vs. 88.7% ± 3.2%, log-rank P = 0.39) or target vessel revascularization (77.1% ± 4.2% vs. 76.1% ± 4.2%, log-rank P = 0.33) between the two groups. Conclusions: Although mortality is not statistically different between DES and BMS for SVG stenosis, BMS is associated with increased risk of revascularization, thus suggesting the superiority of DES over BMS in the long term. © 2011 Wiley Periodicals, Inc. |
| Databáze: | OpenAIRE |
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