Comparison of long-term results of drug-eluting stent and bare metal stent implantation in heart transplant recipients with coronary artery disease.
The aim of the study was to compare long-term results of intracoronary implantation of drug-eluting stents (DES) and bare metal stents (BMS) in patients suffering from transplant coronary artery disease (TxCAD).


METHODS
We performed a retrospective analysis of all intracoronary stent implantations for TxCAD among subjects with at least one follow-up coronary angiography. We identified 28 sirolimus-eluting DES (n = 17) patients, 24 BMS (n = 13 patients), and both DES and BMS (n = 7 patients) implantations among 23 recipients. Mean follow-up after DES was 14 months and after BMS implantation, 20 months. We compared the occurrence of in-stent restenosis (ISR), and patient survival in the context of risk factors that were identified separately for each stent type. Significance was assessed using the log-rank, chi(2) and Mann-Whitney U test.


RESULTS
There were 2 (7%) ISR among DES versus 14 (58%) ISR among BMS (P = .0002) patients, with a longer time of freedom from IRS after DES implantation (P = .022). There were three deaths (18%) among DES, four (31%) with BMS, and one (14%) with DES and BMS (P = NS). Left anterior descending artery was the place of DES implantation in 17 (61%) versus 10 (42%) of BMS cases (P = NS). Risk factor profile was comparable except for a higher age at the time of transplantation (46 +/- 7 vs 41 +/- 6 years; P = .011) and stent implantation (54 +/- 7 vs 49 +/- 6 years; P = .0002) for DES.


CONCLUSIONS
Favorable long-term results of sirolimus-eluting stents over BMS implanted for TxCAD suggested their preferential use in heart transplant recipients.
Zakliczynski
M
M
Department of Cardiac Surgery & Transplantation, Silesian Center for Heart Disease, Zabrze, Poland. zaklimed@onet.pl
Lekston
A
A
Osuch
M
M
Swierad
M
M
Nadziakiewicz
P
P
Przybylski
R
R
Zembala
M
M
D017023:Coronary Angiography; D003327:Coronary Disease / Q000401:mortality / Q000601:surgery*; D023903:Coronary Restenosis / Q000517:prevention & control; D054855:Drug-Eluting Stents; D016027:Heart Transplantation / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008670:Metals; D012189:Retrospective Studies; D020123:Sirolimus / Q000627:therapeutic use*; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D008670:Metals; D020123:Sirolimus