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Long term follow-up of drug eluting versus bare metal stents in the treatment of saphenous vein graft lesions.
MedLine Citation:
PMID:  23239630     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Introduction: The safety and effectiveness of drug-eluting stent (DES) compared to 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 the present 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. Conclusion: These results suggest that the use of DES compared to 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. © 2012 Wiley Periodicals, Inc.
Authors:
Lf Ybarra; Hb Ribeiro; Ah Pozetti; Ca Campos; Rb Esper; Pa Lemos; Ac Lopes; R Kalil-Filho; Sg Ellis; Ee Ribeiro
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-14
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
Affiliation:
Department of Interventional Cardiology, Heart Institute-InCor, University of São Paulo, São Paulo, Brazil.
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