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Stent thrombosis rates the first year and beyond with new- and old-generation drug-eluting stents compared to bare metal stents

Varenhorst, Christoph; Lindholm, Martin; Sarno, Giovanna; Olivecrona, Göran LU ; Jensen, Ulf; Nilsson, Johan; Carlsson, Jörg; James, Stefan and Lagerqvist, Bo (2018) In Clinical Research in Cardiology 107(9). p.816-823
Abstract

Objectives: Old-generation drug-eluting coronary stents (o-DES) have despite being safe and effective been associated with an increased propensity of late stent thrombosis (ST). We evaluated ST rates in o-DES, new-generation DES (n-DES) and bare metal stents (BMS) the first year (< 1 year) and beyond 1 year (> 1 year). Methods: We evaluated all implantations with BMS, o-DES (Cordis Cypher, Boston Scientific Taxus Liberté and Medtronic Endeavor) and n-DES in the Swedish coronary angiography and angioplasty registry (SCAAR) between 1 January 2007 and 8 January 2014 (n = 207 291). All cases of ST (n = 2 268) until 31 December 2014 were analyzed. Results: The overall risk of ST was lower in both n-DES and o-DES compared with BMS up to... (More)

Objectives: Old-generation drug-eluting coronary stents (o-DES) have despite being safe and effective been associated with an increased propensity of late stent thrombosis (ST). We evaluated ST rates in o-DES, new-generation DES (n-DES) and bare metal stents (BMS) the first year (< 1 year) and beyond 1 year (> 1 year). Methods: We evaluated all implantations with BMS, o-DES (Cordis Cypher, Boston Scientific Taxus Liberté and Medtronic Endeavor) and n-DES in the Swedish coronary angiography and angioplasty registry (SCAAR) between 1 January 2007 and 8 January 2014 (n = 207 291). All cases of ST (n = 2 268) until 31 December 2014 were analyzed. Results: The overall risk of ST was lower in both n-DES and o-DES compared with BMS up to 1 year (n-DES versus BMS: adjusted risk ratio (RR) 0.48 (0.41–0.58) and o-DES versus BMS: 0.56 (0.46–0.67), both p < 0.001). From 1 year after stent implantation and onward, the risk for ST was higher in o-DES compared with BMS [adjusted RR, 1.82 (1.47–2.25], p < 0.001). N-DES were associated with similar low ST rates as BMS from 1 year and onward [adjusted RR 1.21 (0.94–1.56), p = 0.135]. Conclusion: New-generation DES were associated with lower ST rates in comparison to BMS during the first-year post-stenting. After 1 year, n-DES and BMS were associated with similar ST rates. Trial Registration: This study was a retrospective observational study and as such did not require clinical trial database registration.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bare metal stents, Drug-eluting stents, Percutaneous coronary intervention, Stent thrombosis
in
Clinical Research in Cardiology
volume
107
issue
9
pages
816 - 823
publisher
Steinkopff
external identifiers
  • scopus:85045424909
ISSN
1861-0684
DOI
10.1007/s00392-018-1252-0
language
English
LU publication?
yes
id
1592987d-b268-4853-a85c-a6f143372faa
date added to LUP
2018-04-26 08:58:25
date last changed
2019-03-19 03:53:41
@article{1592987d-b268-4853-a85c-a6f143372faa,
  abstract     = {<p>Objectives: Old-generation drug-eluting coronary stents (o-DES) have despite being safe and effective been associated with an increased propensity of late stent thrombosis (ST). We evaluated ST rates in o-DES, new-generation DES (n-DES) and bare metal stents (BMS) the first year (&lt; 1 year) and beyond 1 year (&gt; 1 year). Methods: We evaluated all implantations with BMS, o-DES (Cordis Cypher, Boston Scientific Taxus Liberté and Medtronic Endeavor) and n-DES in the Swedish coronary angiography and angioplasty registry (SCAAR) between 1 January 2007 and 8 January 2014 (n = 207 291). All cases of ST (n = 2 268) until 31 December 2014 were analyzed. Results: The overall risk of ST was lower in both n-DES and o-DES compared with BMS up to 1 year (n-DES versus BMS: adjusted risk ratio (RR) 0.48 (0.41–0.58) and o-DES versus BMS: 0.56 (0.46–0.67), both p &lt; 0.001). From 1 year after stent implantation and onward, the risk for ST was higher in o-DES compared with BMS [adjusted RR, 1.82 (1.47–2.25], p &lt; 0.001). N-DES were associated with similar low ST rates as BMS from 1 year and onward [adjusted RR 1.21 (0.94–1.56), p = 0.135]. Conclusion: New-generation DES were associated with lower ST rates in comparison to BMS during the first-year post-stenting. After 1 year, n-DES and BMS were associated with similar ST rates. Trial Registration: This study was a retrospective observational study and as such did not require clinical trial database registration.</p>},
  author       = {Varenhorst, Christoph and Lindholm, Martin and Sarno, Giovanna and Olivecrona, Göran and Jensen, Ulf and Nilsson, Johan and Carlsson, Jörg and James, Stefan and Lagerqvist, Bo},
  issn         = {1861-0684},
  keyword      = {Bare metal stents,Drug-eluting stents,Percutaneous coronary intervention,Stent thrombosis},
  language     = {eng},
  month        = {04},
  number       = {9},
  pages        = {816--823},
  publisher    = {Steinkopff},
  series       = {Clinical Research in Cardiology},
  title        = {Stent thrombosis rates the first year and beyond with new- and old-generation drug-eluting stents compared to bare metal stents},
  url          = {http://dx.doi.org/10.1007/s00392-018-1252-0},
  volume       = {107},
  year         = {2018},
}