MedStar Authors catalog › Details for: Two-year follow-up of outcomes of second-generation everolimus-eluting stents versus first-generation drug-eluting stents for stenosis of saphenous vein grafts used as aortocoronary conduits.
Citation: American Journal of Cardiology. 112(1):61-7, 2013 Jul 1..Journal: The American journal of cardiology.ISSN: 0002-9149.Full author list: Badr S; Barbash IM; Chen F; Dvir D; Kent KM; Kitabata H; Loh JP; Minha S; Pendyala LK; Pichard AD; Satler LF; Suddath WO; Torguson R; Waksman R.UI/PMID: 23561590.Subject(s): *Coronary Stenosis/dt [Drug Therapy] | *Drug-Eluting Stents | *Graft Occlusion, Vascular/dt [Drug Therapy] | *Immunosuppressive Agents/tu [Therapeutic Use] | *Saphenous Vein/tr [Transplantation] | *Sirolimus/aa [Analogs & Derivatives] | *Sirolimus/tu [Therapeutic Use] | Aged | Biological Markers/bl [Blood] | Electrocardiography | Female | Follow-Up Studies | Humans | Male | Percutaneous Coronary Intervention | Proportional Hazards Models | Retrospective Studies | Treatment OutcomeInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access onlineDigital Object Identifier: http://dx.doi.org/10.1016/j.amjcard.2013.02.055 (Click here)Abbreviated citation: Am J Cardiol. 112(1):61-7, 2013 Jul 1.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006.Abstract: Second-generation everolimus-eluting stents (EESs) have demonstrated superiority in efficacy and safety compared with first-generation drug-eluting stents (DESs) in the treatment of native coronary artery lesions. The present study evaluated and compared the safety and efficacy of EESs and first-generation DESs in saphenous vein graft lesions. The EES group consisted of 88 patients with 96 lesions, and the first-generation DES group consisted of 243 patients with 317 lesions (sirolimus-eluting stents, n = 212; paclitaxel-eluting stents, n = 105). The end points included target lesion revascularization, target vessel revascularization, major adverse cardiovascular events (composite of all-cause death, myocardial infarction, and target vessel revascularization), and definite stent thrombosis at 2 years. The groups had similar baseline characteristics and graft ages (128.1 +/- 77.5 vs 132.4 +/- 90.8 months, p = 0.686). The EES group had more type C lesions and less embolic protection device use. The peak postprocedure values of creatinine kinase-MB and troponin I were similar between the 2 groups. Overall, major adverse cardiovascular events occurred in 18.2% of EES patients and 35.0% of first-generation DES patients (p = 0.003), mainly driven by a lower target vessel revascularization rate (6.8% vs 24.5%, p <0.001). The target lesion revascularization rate was lower in the EES group (1.1% vs 11.6%, p = 0.005). Stent thrombosis was low and similar between the 2 groups (0% vs 0.8%, p = 1.000). On multivariate analysis, the type of DES implanted and graft age were the only independent predictors of major adverse cardiovascular events. In conclusion, the superiority of EESs compared with first-generation DESs shown in native artery lesions has been extended to saphenous vein graft lesions and should be considered as the DES of choice for this lesion type. Copyright 2013 Elsevier Inc. All rights reserved.