Long-term clinical outcomes of drug-eluting stents vs bare-metal stents in Chinese patients.
BACKGROUND
There is limited data on the magnitude of the problem of drug-eluting stent (DES) thrombosis in the Asian population.


OBJECTIVE
We evaluated the long-term clinical outcomes of DES vs bare metal stents (BMS) in Chinese patients.


METHODS
From January 2002 to October 2005, 1236 consecutive patients underwent percutaneous coronary intervention with DES or BMS coronary stent implantation at our institution. We analyzed major clinical end points like all-cause mortality, cardiovascular death, myocardial infarction, target lesion revascularization (TLR), and stent thrombosis.


RESULTS
The 3-year cumulative rates of all-cause mortality, cardiovascular death, and myocardial infarction were significantly lower in the DES group (3.4%, 0.9%, 3.6%) when compared with the BMS group (7.5%, 4.4%, 6.2%; P < .05). No significant differences were found in the 3-year cumulative rates for TLR or stent thrombosis when comparing the DES group (8.3%, 1.63%) vs the BMS group (9.6%, 1.6%; P > .05). However, after 1 year, there were 8 episodes of stent thrombosis in the DES group vs 1 episode of stent thrombosis in the BMS group (P = .04).


CONCLUSIONS
Drug-eluting stents are associated with a significant reduction in the 3-year cumulative rates of all-cause mortality, cardiovascular death, and myocardial infarction when compared to BMS. However, there were no significant differences in the cumulative rates of TLR or stent thrombosis at 3 years. Stent thrombosis after 1 year was more common in the DES group, but this did not translate to increased mortality. The suggestion that DES might confer a mortality benefit should be interpreted with caution as there could be several confounding factors that were not identified in our study.
Ho
Hee-Hwa
HH
Cardiology Division, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong.
Pong
Vincent
V
Siu
Chung-Wah
CW
Jim
Man-Hong
MH
Miu
Raymond
R
Yiu
Kai-Hang
KH
Ko
Ryan
R
Tse
Hung-Fat
HF
Kwok
On-Hing
OH
Chow
Wing-Hing
WH
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D044466:Asian People / Q000706:statistics & numerical data; D002681:China; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000208:ethnology; D016016:Proportional Hazards Models; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D015607:Stents; D013927:Thrombosis / Q000208:ethnology; D013997:Time Factors; D016896:Treatment Outcome
D008670:Metals