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Long term follow-up of drug eluting versus bare metal stents in the treatment of saphenous vein graft lesions.
Ybarra, Luiz F; Ribeiro, Henrique B; Pozetti, Antonio H; Campos, Carlos A; Esper, Rodrigo B; Lemos, Pedro A; Lopes, Augusto C; Kalil-Filho, Roberto; Ellis, Stephen G; Ribeiro, Expedito E.
Affiliation
  • Ybarra LF; Department of Interventional Cardiology, Heart Institute-InCor, University of São Paulo, São Paulo, Brazil.
Catheter Cardiovasc Interv ; 82(7): E856-63, 2013 Dec 01.
Article in En | MEDLINE | ID: mdl-23239630
INTRODUCTION: The safety and effectiveness of drug-eluting stent (DES) compared with bare metal stents (BMS) for the treatment of saphenous vein graft (SVG) disease is controversial, especially because of the lack of long-term follow-up. The aim of this study was to address the late outcome of DES versus BMS for the treatment of SVG lesions. METHODS: A matched, case-control study included 82 patients in each group. Patients groups were matched by gender, age, clinical presentation, and diabetes. The primary study end point was occurrence of major adverse cardiovascular events (MACE). Secondary end points included death, cardiac death, myocardial infarction (MI), and target vessel revascularization (TVR). RESULTS: Clinical and angiographic characteristics were similar between the groups. At 6 months, TVR (hazard ratio [HR] 6.12, 95% confidence interval [CI] 1.39 to 26.93, P = 0.05), and MACE (HR 2.54, 95% CI 1.08 to 5.98, P = 0.04) were higher in the BMS group. At 4 years the risks of MI (P = 0.21), TVR (P = 0.99), and MACE (P = 0.21) were similar between both groups. However, the rates of death (HR 2.74, 95% CI 1.11 to 6.74, P = 0.04) and cardiac death (HR 4.26, 95% CI 1.59 to 11.35, P = 0.01) were significantly higher in the BMS group. CONCLUSIONS: These results suggest that the use of DES compared with BMS in the treatment of SVG lesions reduces TVR and MACE at 6 months of follow-up, a benefit that was lost over the next 3-4 years.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Saphenous Vein / Stents / Coronary Artery Bypass / Drug-Eluting Stents / Percutaneous Coronary Intervention / Graft Occlusion, Vascular / Metals Type of study: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: Catheter Cardiovasc Interv Journal subject: CARDIOLOGIA Year: 2013 Type: Article Affiliation country: Brazil

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Saphenous Vein / Stents / Coronary Artery Bypass / Drug-Eluting Stents / Percutaneous Coronary Intervention / Graft Occlusion, Vascular / Metals Type of study: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: Catheter Cardiovasc Interv Journal subject: CARDIOLOGIA Year: 2013 Type: Article Affiliation country: Brazil