title: Efficacy of sirolimus-eluting stents compared with bare metal stents for saphenous vein graft intervention.
abstract: Saphenous vein graft (SVG) intervention is associated with a significantly increased rate of periprocedural complications and late clinical and angiographic restenosis. We examined the efficacy and safety of sirolimus-eluting stents (SESs; Cypher) compared with bare metal stents (BMSs) in SVG intervention. Forty-eight patients who had 50 SVG lesions and underwent standard percutaneous coronary intervention with SESs (SES group) were compared with 57 patients who had 64 SVG lesions and underwent intervention with BMSs (BMS group). All patients received distal protection devices during SVG intervention. In-hospital, 30-day, 6-month, and 1-year clinical outcomes in the 2 groups were compared. Baseline clinical and procedural characteristics were balanced between groups. There were no deaths or Q-wave myocardial infarctions during the index hospitalization, but compared with the BMS group, patients in the SES group had significantly fewer non-Q-wave myocardial infarctions (4% vs 21%, p = 0.01), which was mainly attributed to increased periprocedural creatine kinase-MB levels. At 30-day, 6-month, and 1-year follow-ups, all clinical outcomes were similar between groups. Event-free survival at 1 year was also similar between groups (p = 0.84). In conclusion, the use of SESs in patients who undergo SVG intervention with a distal protection device is clinically safe and feasible but is not associated with decreased clinical events up to 1 year compared with BMSs.
authors.affiliation: Washington Hospital Center, Washington, DC, USA.
authors.forename: William W
authors.initials: WW
authors.lastname: Chu
authors.forename: Seung-Woon
authors.initials: SW
authors.lastname: Rha
authors.forename: Pramod K
authors.initials: PK
authors.lastname: Kuchulakanti
authors.forename: Edouard
authors.initials: E
authors.lastname: Cheneau
authors.forename: Rebecca
authors.initials: R
authors.lastname: Torguson
authors.forename: Ellen
authors.initials: E
authors.lastname: Pinnow
authors.forename: Jana
authors.initials: J
authors.lastname: Alexieva-Fournadjiev
authors.forename: Augusto D
authors.initials: AD
authors.lastname: Pichard
authors.forename: Lowell F
authors.initials: LF
authors.lastname: Satler
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Kent
authors.forename: Joseph
authors.initials: J
authors.lastname: Lindsay
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D052279:Creatine Kinase, MB Form / Q000097:blood; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D009203:Myocardial Infarction / Q000097:blood / Q000628:therapy; D009204:Myocardial Revascularization; D012501:Saphenous Vein / Q000637:transplantation*; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents
chemical_list: D007166:Immunosuppressive Agents; D052279:Creatine Kinase, MB Form; D020123:Sirolimus