Two-year clinical outcomes following elective drug-eluting versus bare-metal stent implantation: results from a large single-center database.
BACKGROUND
In response to the increasing concern with the safety of the drug-eluting stent (DES), the present study aimed to evaluate the long-term safety and efficacy of DES used for a Chinese patient population.


METHODS
All patients, who underwent an index elective percutaneous coronary intervention with an implantation of either DES or bare-metal stent (BMS) in a single institution from April 2004 to December 2006, were included in the analysis. A propensity-score matching technique was applied to adjust and to minimize the impact of confounding factors.


RESULTS
Overall, there were 1465 patients (20.2%) who had undergone an implantation of only BMS, and 5769 patients (79.8%) of only DES. The propensity-score matching technique set up 1321 pairs of patients for analysis. There were no significant differences between the rates of stent thrombosis (definite and probable) of the two groups (1.06% vs 1.21%, P = 0.8580). Although rates of mortality and myocardial infarction (MI) during the 2-year follow-up period had not differed significantly, rates of death/MI (3.0% vs 4.5%, P = 0.0263), target-lesion revascularization (TLR, 3.2% vs 8.5, P = 0.0001), target-vessel revascularization (TVR, 5.8% vs 9.5%, P < 0.0001) and any revascularization (10.0% vs 13.3%, P = 0.0066) were significantly lower for the DES group than for the BMS group. Among the patients in whom devices were implanted for off-label indications, the propensity-score matched rates of stent thrombosis, mortality, MI, and death/MI were not significantly different, while rates of TLR, TVR and any revascularization were significantly lower for the DES group than for the BMS group.


CONCLUSIONS
During the 2 years of follow-up post stenting, DES use is associated with lower rates of death/MI, TLR, TVR and any revascularization, compared with BMS, in propensity-score matched Chinese patient populations. In the setting of off-label usage, DES use is also associated with similar advantages.
Gao
Run-lin
RL
Department of Cardiology, Cardiovascular Institute & Fu Wai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China. gaorunlin@263.net
Xu
Bo
B
Chen
Ji-lin
JL
Yang
Yue-jin
YJ
Qiao
Shu-bin
SB
Wang
Yang
Y
Dou
Ke-fei
KF
Qin
Xue-wen
XW
Yao
Min
M
Liu
Hai-bo
HB
Wu
Yong-jian
YJ
Yuan
Jin-qing
JQ
Chen
Jue
J
You
Shi-jie
SJ
Dai
Jun
J
Ma
Wei-hua
WH
Li
Wei
W
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality; D016208:Databases, Factual; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality; D015607:Stents / Q000009:adverse effects