Document Detail

Comparison of bare-metal stents and drug-eluting stents in coronary ostial lesions (from the National Heart, Lung, and Blood Institute Dynamic Registry).
MedLine Citation:
PMID:  22762712     Owner:  NLM     Status:  MEDLINE    
We compared the effectiveness of drug-eluting stents (DESs) to bare-metal stents (BMSs) in ostial lesions from an unrestricted patient cohort with 3-year follow-up. DESs have proved more effective at decreasing repeat revascularization rates compared to BMSs in patients with uncomplicated coronary artery disease. Whether DESs provide similar benefits in ostial lesions is not clearly defined. We analyzed data from 775 patients in the National, Heart, Lung, and Blood Institute Dynamic Registry undergoing stenting of ostial lesions with DESs or BMSs. Patients were followed for 3 years for the occurrence of myocardial infarction (MI), repeat revascularization (coronary bypass surgery/repeat percutaneous coronary intervention), and death. In total 439 patients had 464 ostial lesions treated with BMSs and 336 patients had 351 ostial lesions treated with DESs. Adjusted DES versus BMS 3-year hazard ratios were 1.03 (95% confidence interval 0.60 to 1.78, p = 0.90) for death, 1.40 (0.83 to 2.37, p = 0.21) for MI, and 0.81 (0.59 to 1.11, p = 0.19) for repeat revascularization. In patients undergoing percutaneous coronary intervention for aorto-ostial disease (n = 200), death and repeat revascularization did not differ between stent types, but DES-treated patients had more MI during follow-up. For coronary ostial disease (n = 574), 3-year observed rates of death or MI did not differ; however, repeat revascularization was more common in the BMS group. In conclusion, use of DESs for ostial lesions was associated with no difference in the hazard of death, MI, or overall rates of repeat revascularization compared to BMS use.
Samip Vasaiwala; Helen Vlachos; Faith Selzer; Oscar Marroquin; Suresh Mulukutla; J Dawn Abbott; David O Williams
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2012-07-03
Journal Detail:
Title:  The American journal of cardiology     Volume:  110     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-01     Completed Date:  2013-01-04     Revised Date:  2013-07-12    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1113-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Brigham and Women's Hospital, Boston, Massachusetts, USA.
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MeSH Terms
Chi-Square Distribution
Coronary Angiography
Coronary Disease / mortality,  therapy*
Drug-Eluting Stents
Hospital Mortality
National Heart, Lung, and Blood Institute (U.S.)
Proportional Hazards Models
Risk Factors
Statistics, Nonparametric
Treatment Outcome
United States
Grant Support
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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