Bare-metal stents versus drug-eluting stents in large (≥3.5mm) single coronary artery: angiographic and clinical outcomes at 6 months.
BACKGROUND
Although drug-eluting stents (DES) have been shown to dramatically reduce restenosis and improve the rate of event-free survival in large randomized trials, the benefit of DES appears to be limited to restenosis. In large arteries, it is not clear which type of stent is more superior in angiographic and clinical outcomes between DES and bare-metal stents (BMS). We compared the angiographic and clinical outcomes of DES versus BMS in large arteries (> or = 3.5 mm).


METHODS
Two hundred and forty patients from March 2002 to March 2007 received stents; 196 patients were treated with DES (44.9% sirolimus-eluting stents; 43.9% paclitaxel-eluting stents; 11.2% zotarolimus-eluting stents) and 44 with cobalt-chromium BMS for single de novo lesions in a large vessel. All subjects received aspirin, clopidogrel, and/or cilostazol as the standard antiplatelet regimen. The angiographic and clinical outcomes were evaluated at 6 months.


RESULTS
For the baseline characteristics, there were no significant differences between the DES and BMS groups. In addition, for the initially implanted stent there was no difference in the length, stent diameter, and lesion site between the two groups. After 6 months, the follow-up angiogram showed that in-stent diameter restenosis and late loss was more common with BMS than DES (39+/-21% vs. 19+/-17%, p=0.007; 1.44+/-0.83 mm vs. 0.62+/-0.58 mm, p=0.009, respectively). However, the target-lesion revascularization/target-vessel revascularization, and total major adverse cardiac events showed no significant differences between the groups (5.3% vs. 3.6%, p=0.62; 5.3% vs. 4.6%, p=0.86, respectively).


CONCLUSIONS
The DES and cobalt-chromium BMS placed in large coronary arteries showed equally favorable 6-month clinical outcomes, although the 6-month angiographic results appeared more favorable in the DES group than in the BMS group.
Na
Jin Oh
JO
Cardiovascular Center, Korea University Guro Hospital, 97 Gurodong-Gil, Guro-Gu, Seoul 152 703, Republic of Korea.
Kim
Jin Won
JW
Choi
Cheol Ung
CU
Choi
Un Jung
UJ
Shin
Seung Yong
SY
Lim
Hong Euy
HE
Kim
Eung Ju
EJ
Rha
Seung-Woon
SW
Park
Chang Gyu
CG
Seo
Hong Seog
HS
Oh
Dong Joo
DJ
D000368:Aged; D002858:Chromium Alloys; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000517:prevention & control; D003331:Coronary Vessels; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015607:Stents; D016896:Treatment Outcome
D002858:Chromium Alloys