Document Detail


A comparative analysis of major clinical outcomes using drug-eluting stents versus bare-metal stents in a large consecutive patient cohort.
MedLine Citation:
PMID:  20839351     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To ascertain the long-term safety, efficacy, and pattern of use of drug-eluting stents (DES) in routine clinical practice.
METHODS: We analyzed a registry of 6,583 consecutive patients undergoing percutaneous coronary intervention (PCI), of whom 2,633 were treated using DES (DES group) and 3,950 were treated using bare-metal stents (BMS group). Propensity score was used for stratified analysis of outcomes and for matching. Outcomes were total mortality, myocardial infarction (MI), repeat target vessel revascularization (TVR) rates, and risk-adjusted event-free survival.
RESULTS: Follow-up time was 6 months to 5.18 years (mean: 3 years). Patients in the DES group were more likely to be diabetic and had use of longer or more stents, treatment of more lesions and of more proximal main vessels. After propensity score matching, the cumulative mortality was 12.85% in the DES group versus 14.14% in the BMS group (P = 0.001). Use of DES reduced the occurrence of MI (5.17% vs.5.83%, P = 0.046), of clinically driven TVR (9.76% vs. 12.28%, P < 0.001) and of the composite endpoint of death/MI/TVR (23.38% vs. 26.07%; P < 0.001).
CONCLUSIONS: Our risk-adjusted event-free survival analysis indicates a prognostic benefit for DES utilization that sustains up to 5 years following PCI.
Authors:
Tamir Bental; Abid Assali; Hana Vaknin-Assa; Eli I Lev; David Brosh; Shmuel Fuchs; Alexander Battler; Ran Kornowski
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  76     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-14     Completed Date:  2011-01-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  374-80     Citation Subset:  IM    
Affiliation:
Cardiology Department, Rabin Medical Center, Tel-Aviv University, Israel. tamir_b@zahav.net.il
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon, Coronary / adverse effects,  instrumentation*,  mortality,  utilization
Chi-Square Distribution
Cohort Studies
Disease-Free Survival
Drug-Eluting Stents* / utilization
Female
Humans
Israel
Kaplan-Meier Estimate
Linear Models
Logistic Models
Male
Metals*
Middle Aged
Myocardial Infarction / etiology
Physician's Practice Patterns
Propensity Score
Prosthesis Design
Registries
Risk Assessment
Risk Factors
Stents* / utilization
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Metals
Comments/Corrections
Comment In:
Catheter Cardiovasc Interv. 2010 Sep 1;76(3):381-2   [PMID:  20839352 ]

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


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