0234: Drug-eluting stents versus bare-metal stent in large coronary arteries - 12/02/16
Résumé |
Background |
Although drug-eluting stents (DES) have been shown to dramatically reduce restenosis and improve the rate of event-free survival, the benefit of DES appears to be limited to restenosis. In this retrospective, single-center study we aimed to compare the long-term outcomes of DES versus bare-metal stent (BMS) in large coronary arteries (diameter≥3.5mm).
Methods |
A total of 164 consecutive patients (mean age 60 years) required percutaneous coronary intervention with stents≥3.5mm in diameter, 84 were BMS and 80 DES. The primary endpoint was major adverse cardiac events (MACE) defined as angiographically defined in-stent restenosis (ISR), stent thrombosis and death from any cause.
Results |
A mean clinical follow up of 28 months was obtained. The DES group had higher rates of diabetes (63% vs 37%, p=0.001), previous CAD (74% vs 25%, p=0.001) and previous PCI (69% vs 31%, p=<0.04). There was no significant difference between the two groups regarding the rate of hyper-tension, dyslipidemia, smokers and the mean left ventricular ejection fraction. There was a higher average stent length in the DES group (18.7 vs 16.3, p=0.011) as well as a lower average stent diameter (3.54 vs 3.63, p=0.003). There was a significant difference in MACE between the two groups in favour of DES (11.3% DES vs 23.8% BMS group, p=0.04) at 28 months. The rate of in-stent restenosis (ISR) was significantly reduced among patients receiving DES with ISR rates of 15.8% among patients receiving DES compared to 41.7% among those receiving BMS (p=0.025). There were no significant differences in the rate of death or stent thrombosis.
Conclusion |
In patients requiring stenting of large coronary arteries, there was reduced MACE in patients treated with DES. This benefit was primarily driven by decreased in-stent restenosis rate.
Le texte complet de cet article est disponible en PDF.Vol 8 - N° 1
P. 11 - janvier 2016 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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