Long-term clinical outcomes of real-world experience using sirolimus-eluting stents in saphenous vein graft disease.
Catheter Cardiovasc Interv
; 71(7): 886-93, 2008 Jun 01.
Article
in En
| MEDLINE
| ID: mdl-18412238
ABSTRACT
OBJECTIVE:
To evaluate the long-term clinical outcomes of patients undergoing percutaneous coronary intervention for saphenous vein graft (SVG) disease. Specifically, we compared clinical endpoints of patients who received sirolimus-eluting stents (SES) versus bare-metal stents (BMS) for SVG disease.BACKGROUND:
A recent small randomized-controlled trial (RCT) reported increased mortality with the use of SES in SVG disease.METHODS:
We retrospectively identified patients who underwent SES placement for a SVG lesion(s) at our institutions over a 4-year period. The procedural and medical records were reviewed to identify predetermined clinical outcomes.RESULTS:
318 patients who underwent SES placement for a SVG lesion were identified. 7 patients were lost to follow-up. 141/311 patients (45%) received SES, while 170/311 (55%) received BMS. At a mean follow-up of 34 months, there was a reduction in target lesion revascularization (TLR) (7% vs. 14%, P = 0.07) without an increased risk of mortality (6% vs. 12%, P = 0.06) in patients who received SES compared to patients who received BMS. When compared to the recent RCT's SES patients at long-term follow-up, our SES patients had significantly less mortality; rates of myocardial infarction, TLR, target vessel revascularization, and major adverse cardiac events; and were more likely to be taking dual antiplatelet and statin medications.CONCLUSION:
Our results support that SES used in SVG lesions result in a reduction in TLR without an increased risk of mortality, and therefore may be an equally safe and feasible technique for revascularization with excellent long-term clinical outcomes. These patients may benefit from prolonged dual antiplatelet and statin medication regimens.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Saphenous Vein
/
Cardiovascular Agents
/
Angioplasty, Balloon, Coronary
/
Stents
/
Sirolimus
/
Coronary Restenosis
/
Drug-Eluting Stents
/
Graft Occlusion, Vascular
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
En
Journal:
Catheter Cardiovasc Interv
Journal subject:
CARDIOLOGIA
Year:
2008
Document type:
Article
Affiliation country:
Estados Unidos