Advanced

Long-term safety and efficacy of drug-eluting and bare metal stents in saphenous vein grafts

Frobert, Ole; Scherstén, Fredrik LU ; James, Stefan K.; Carlsson, Jorg and Lagerqvist, Bo (2012) In American Heart Journal 164(1). p.87-93
Abstract
Background Long-term safety and efficacy data of drug-eluting stents (DESs) in saphenous vein grafts (SVGs) are lacking. This study sought to compare the clinical outcomes of DES versus bare metal stents (BMS) in SVGs. Methods We studied all stent implantations in SVGs in Sweden during 74 months between 2005 and 2011 registered in the Swedish Coronary Angiography and Angioplasty Registry. We evaluated outcome in patients who received DES compared with those who received BMS after adjustments for differences in clinical, vessel, and lesion characteristics. Results Mean follow-up time was 3 years and 4 months. A total of 4,576 stents, implanted at 3,063 procedures, were included in the analysis of which 2,499 stents (54.6 %) were BMS and... (More)
Background Long-term safety and efficacy data of drug-eluting stents (DESs) in saphenous vein grafts (SVGs) are lacking. This study sought to compare the clinical outcomes of DES versus bare metal stents (BMS) in SVGs. Methods We studied all stent implantations in SVGs in Sweden during 74 months between 2005 and 2011 registered in the Swedish Coronary Angiography and Angioplasty Registry. We evaluated outcome in patients who received DES compared with those who received BMS after adjustments for differences in clinical, vessel, and lesion characteristics. Results Mean follow-up time was 3 years and 4 months. A total of 4,576 stents, implanted at 3,063 procedures, were included in the analysis of which 2,499 stents (54.6 %) were BMS and 2,077 (45.4%) were DES. The outcome analysis was based on 190 stent thromboses, 898 restenoses, and 523 deaths. The incidence of stent thrombosis did not differ between groups. When adjusted for baseline characteristics, including a propensity score for receiving DES, the incidence of restenosis was significantly lower with DES as compared with BMS (risk ratio 0.83, 95% CI 0.70-0.97, P = .019). There was a difference in mortality in the crude analysis between DES and BMS, and after multivariable adjustment, this difference remained statistically significant (risk ratio 0.80, CI 0.65-0.99, P = .038). Conclusions The use of DES compared with BMS in SVGs was associated with a significantly lower adjusted incidence of restenosis and death in this large, national, all-encompassing propensity adjusted observational study. (Am Heart J 2012;164:87-93.) (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
American Heart Journal
volume
164
issue
1
pages
87 - 93
publisher
Mosby
external identifiers
  • wos:000306366900013
  • scopus:84863637947
ISSN
1097-6744
DOI
10.1016/j.ahj.2012.04.012
language
English
LU publication?
yes
id
cc322d5e-04c8-423c-9be9-0ecb7fd0b679 (old id 2991662)
date added to LUP
2012-09-03 07:17:03
date last changed
2017-01-01 04:13:24
@article{cc322d5e-04c8-423c-9be9-0ecb7fd0b679,
  abstract     = {Background Long-term safety and efficacy data of drug-eluting stents (DESs) in saphenous vein grafts (SVGs) are lacking. This study sought to compare the clinical outcomes of DES versus bare metal stents (BMS) in SVGs. Methods We studied all stent implantations in SVGs in Sweden during 74 months between 2005 and 2011 registered in the Swedish Coronary Angiography and Angioplasty Registry. We evaluated outcome in patients who received DES compared with those who received BMS after adjustments for differences in clinical, vessel, and lesion characteristics. Results Mean follow-up time was 3 years and 4 months. A total of 4,576 stents, implanted at 3,063 procedures, were included in the analysis of which 2,499 stents (54.6 %) were BMS and 2,077 (45.4%) were DES. The outcome analysis was based on 190 stent thromboses, 898 restenoses, and 523 deaths. The incidence of stent thrombosis did not differ between groups. When adjusted for baseline characteristics, including a propensity score for receiving DES, the incidence of restenosis was significantly lower with DES as compared with BMS (risk ratio 0.83, 95% CI 0.70-0.97, P = .019). There was a difference in mortality in the crude analysis between DES and BMS, and after multivariable adjustment, this difference remained statistically significant (risk ratio 0.80, CI 0.65-0.99, P = .038). Conclusions The use of DES compared with BMS in SVGs was associated with a significantly lower adjusted incidence of restenosis and death in this large, national, all-encompassing propensity adjusted observational study. (Am Heart J 2012;164:87-93.)},
  author       = {Frobert, Ole and Scherstén, Fredrik and James, Stefan K. and Carlsson, Jorg and Lagerqvist, Bo},
  issn         = {1097-6744},
  language     = {eng},
  number       = {1},
  pages        = {87--93},
  publisher    = {Mosby},
  series       = {American Heart Journal},
  title        = {Long-term safety and efficacy of drug-eluting and bare metal stents in saphenous vein grafts},
  url          = {http://dx.doi.org/10.1016/j.ahj.2012.04.012},
  volume       = {164},
  year         = {2012},
}