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Seven-year safety and efficacy of the unrestricted use of drug-eluting stents in saphenous vein bypass grafts.
MedLine Citation:
PMID:  21542111     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: The aim was to investigate the 7-year clinical outcomes of patients treated with either drug-eluting stents (DES) or bare-metal stents (BMS) for saphenous vein graft disease (SVG). BACKGROUND: Atherosclerotic disease in SVG has several peculiarities which make it not possible to extrapolate outcomes of the use of DES as compared to BMS, from outcomes observed in native coronary arteries. To date no long-term safety and efficacy results for DES in SVG have been published. METHODS: Between January, 2000 and December, 2005 a total of 250 consecutive patients with saphenous vein graft disease were sequentially treated with DES (either sirolimus- or paclitaxel-eluting stents) or with BMS. Yearly follow-up was performed. RESULTS: At 7¼ years, a total of 101 patients died (58 [46%] in the BMS group and 43 [42%] in the DES group, p-value= 0.4). There was no significant difference in the combined endpoint mortality or myocardial infarction. Cumulative target vessel revascularisation (TVR) was higher in the BMS group compared to the DES group (41% vs. 29% respectively; adjusted hazard ratio [HR] 0.63, 95% confidence interval [CI]: 0.39 to 1.0). The cumulative incidence of major adverse cardiac events was 73% versus 68% in the BMS and DES groups respectively (adjusted HR 0.93, 95% CI: 0.67 to 1.3). CONCLUSIONS: In the present study, the unrestricted use of DES for SVG lesions appeared safe and effective up to 7¼ years- and the use of DES resulted in a clinically relevant lower rate of TVR. © 2011 Wiley-Liss, Inc.
Authors:
Sjoerd T Nauta; Nicolas M Van Mieghem; Michael Magro; Jaap W Deckers; Cihan Simsek; Robert Jan Van Geuns; Wim J Van Der Giessen; Peter De Jaegere; Evelyn Regar; Ron T Van Domburg; Patrick W Serruys
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-3
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-4     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 © 2011 Wiley-Liss, Inc.
Affiliation:
Thoraxcenter, Erasmus Medical Center, Ba-559 Dr. Molewaterplein 40, 3015GD Rotterdam, the Netherlands.
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