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Choice of Stent for Percutaneous Coronary Intervention of Saphenous Vein Grafts.

Mamas

Choice of Stent for Percutaneous Coronary Intervention of Saphenous Vein Grafts. Thumbnail


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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.

Acceptance Date Mar 3, 2017
Publication Date Apr 12, 2017
Publicly Available Date Mar 29, 2024
Journal Circulation: Cardiovascular Interventions
Print ISSN 1941-7640
Publisher American Heart Association
DOI https://doi.org/10.1161/CIRCINTERVENTIONS.116.004457
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 ou
Publisher URL http://circinterventions.ahajournals.org/content/10/4/e004457

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