Literature DB >> 19110803

Four-year safety and efficacy of the unrestricted use of sirolimus- and paclitaxel-eluting stents in coronary artery bypass grafts.

Piet-Hein van Twisk1, Joost Daemen, Neville Kukreja, Ron T van Domburg, Patrick W Serruys.   

Abstract

OBJECTIVES: Recently, concerns were raised about the relative long-term safety and efficacy of drug-eluting stents (DES) in saphenous vein bypass grafts (SVG). Our objective was to assess the 4-year relative safety and efficacy of the unrestricted use of drug-eluting stents (DES) as compared to bare metal stents (BMS) in saphenous vein bypass grafts (SVG).
METHODS: Between April 16, 2002 and December 2005 a total of 122 consecutive patients were treated with either sirolimus- or paclitaxel-eluting stents for saphenous vein graft disease. These patients were compared with 128 consecutive patients treated with BMS in the immediate preceding period (January 1, 2000 to April 2002).
RESULTS: At 4-years the cumulative survival rate in the DES group was 77.5% versus 73.0% in the BMS group (adjusted HR 1.09; 95% CI 0.63-1.90, Logrank p=0.65). The cumulative survival free of major adverse cardiac events (MACE: death, myocardial infarction and target vessel revascularisation) was 61.5% vs. 46.8% in the DES and BMS groups respectively (adjusted HR 0.77, 95% CI; 0.51-1.16) due to a higher event free survival of clinically driven target vessel revascularisation in the DES group as compared to the BMS group (81.6% vs. 69.0%; adjusted HR 0.53; 95% CI 0.27-1.05).
CONCLUSIONS: In the present study, the use of DES for SVG PCI was associated a similar safety profile and there was a trend towards lower rates of TVR and MACE at four years as compared to BMS.

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Year:  2008        PMID: 19110803     DOI: 10.4244/eijv4i3a57

Source DB:  PubMed          Journal:  EuroIntervention        ISSN: 1774-024X            Impact factor:   6.534


  2 in total

1.  Comparison of drug-eluting and bare metal stents for saphenous vein graft lesions (from the National Heart, Lung, and Blood Institute Dynamic Registry).

Authors:  Drew E Baldwin; J Dawn Abbott; Jeffrey C Trost; Helen A Vlachos; Faith Selzer; Ruchira Glaser; Robert L Wilensky; James N Slater; Serge Doucet; Srihari S Naidu; Herbert D Aronow; David O Williams
Journal:  Am J Cardiol       Date:  2010-08-11       Impact factor: 2.778

2.  Drug-eluting versus bare-metal stent for treatment of saphenous vein grafts: a meta-analysis.

Authors:  Pascal Meier; Emmanouil S Brilakis; Roberto Corti; Guido Knapp; Mehdi H Shishehbor; Hitinder S Gurm
Journal:  PLoS One       Date:  2010-06-10       Impact factor: 3.240

  2 in total

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