Iqbal, J and Kwok, CS and Kontopantelis, E and de Belder, MA and Ludman, PF and Large, A and Butler, R and Gamal, A and Kinnaird, T and Zaman, A and Mamas, MA (2017) Choice of Stent for Percutaneous Coronary Intervention of Saphenous Vein Grafts. Circulation: Cardiovascular Interventions, 10 (4). ISSN 1941-7632

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Abstract

BACKGROUND: There are limited data on comparison of contemporary drug-eluting stent (DES) platforms, previous generation DES, and bare-metal stents (BMS) for percutaneous coronary intervention in saphenous vein grafts (SVG). We aimed to assess clinical outcomes following percutaneous coronary intervention to SVG in patients receiving bare-metal stents (BMS), first-generation DES, and newer generation DES in a large unselected national data set from the BCIS (British Cardiovascular Intervention Society). METHODS AND RESULTS: Patients undergoing percutaneous coronary intervention to SVG in the United Kingdom from January 2006 to December 2013 were divided into 3 groups according to stent use: BMS, first-generation DES, and newer generation DES group. Study outcomes included in-hospital major adverse cardiovascular events, 30-day mortality, and 1-year mortality. Patients (n=15 003) underwent percutaneous coronary intervention to SVG in England and Wales during the study period. Of these, 38% received BMS, 15% received first-generation DES, and 47% received second-generation DES. The rates of in-hospital major adverse cardiovascular events were significantly lower in patients treated with second-generation DES (odds ratio, 0.51; 95% confidence interval, 0.38-0.68; P<0.001), but not with first-generation DES, compared with BMS-treated patients. Similarly, 30-day mortality (odds ratio, 0.43; 95% confidence interval, 0.32-0.59; P<0.001) and 1-year mortality (odds ratio, 0.60; 95% confidence interval, 0.51-0.71; P<0.001) were lower in patients treated with second-generation DES, but not with first-generation DES, compared with the patients treated with BMS. CONCLUSIONS: Patients receiving second-generation DES for the treatment SVG disease have lower rates of in-hospital major adverse cardiovascular events, 30-day mortality, and 1-year mortality, compared with those receiving BMS.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via American Heart Association at http://dx.doi.org/10.1161/CIRCINTERVENTIONS.116.004457 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: aged, coronary artery disease, female, follow-up studies, humans, incidence, male, percutaneous coronary intervention, postoperative complications, prosthesis design, retrospective studies, risk factors, saphenous vein, stents, survival rate, treatment outcome, united kingdom, cardiovascular diseases, coronary artery bypass, mortality, percutaneous coronary intervention, saphenous vein graft
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
Divisions: Faculty of Medicine and Health Sciences > Institute for Science and Technology in Medicine
Related URLs:
Depositing User: Symplectic
Date Deposited: 04 Jul 2017 15:04
Last Modified: 12 Oct 2017 01:30
URI: http://eprints.keele.ac.uk/id/eprint/3727

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