| Drug-eluting versus bare-metal stents for treating saphenous vein grafts. | |
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MedLine Citation:
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PMID: 19781425 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Current data show conflicting results regarding safety and efficacy of drug-eluting stents (DES) versus bare-metal stents (BMS) for treating saphenous vein grafts (SVG). Our objective was to compare DES with BMS for SVG intervention. METHODS: Patients undergoing stenting with DES or BMS to SVG from January 2000 to June 2007 were included. To eliminate any unobserved bias regarding stent selection, the BMS cohort was divided into pre- and post-2003 when DES became available. Adjusted Cox analysis compared DES with pre- and post-2003 BMS patients. The primary end point was a composite of all-cause mortality, myocardial infarction, or target lesion revascularization. RESULTS: Of the total 566 patients, 217 (38%) received DES, 110 (20%) received BMS post-2003, and 239 (42%) received BMS pre-2003. Median follow-up was 2.9 years (interquartile range 1.4-4.9 years). There was a trend toward lower primary end point with DES compared to post-2003 BMS (91 events, adjusted hazard ratio 0.61, 95% CI 0.35-1.07, P = .08). However, despite 179 events, DES use was not associated with lower primary end point compared with pre-2003 BMS (adjusted hazard ratio 0.61, 95% CI 0.28-1.35, P = .23). CONCLUSIONS: Although DES showed a trend toward a lower primary end point when compared with BMS post-2003, this association was no longer present when DES was compared to pre-2003 BMS. These results are consistent with the preponderance of available data and indicate that unobserved bias in observational registries may explain the reported benefit of DES over BMS for treating SVG. |
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Authors:
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Mehdi H Shishehbor; Riem Hawi; Inder M Singh; E Murat Tuzcu; Deepak L Bhatt; Stephen G Ellis; Samir R Kapadia |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: American heart journal Volume: 158 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-09-28 Completed Date: 2009-10-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 637-43 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH 44114, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Coronary Angiography Coronary Disease / surgery* Drug-Eluting Stents* Female Follow-Up Studies Graft Occlusion, Vascular / epidemiology, surgery* Humans Incidence Male Myocardial Revascularization / methods* Retrospective Studies Saphenous Vein / transplantation* Treatment Outcome United States / epidemiology |
| Grant Support | |
ID/Acronym/Agency:
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K12 HD049091/HD/NICHD NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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