Comparison of sirolimus-eluting stents with paclitaxel-eluting stents in saphenous vein graft intervention (from a multicenter Southern California Registry).
This study was designed to compare the safety and efficacy of sirolimus-eluting stents (SESs) to paclitaxel-eluting stents (PESs) in percutaneous intervention of saphenous vein graft (SVG) lesions. SVGs develop atherosclerosis at high rates and often require repeat revascularization. Percutaneous intervention with drug-eluting stents has become the preferred method of revascularization due to higher restenosis with bare metal stents and increased morbidity and mortality with repeat coronary artery bypass grafting. We sought to compare the rate of major adverse cardiac events and stent thrombosis between SESs and PESs in patients undergoing SVG intervention. A multicenter analysis of 172 patients with SVG lesions treated with SESs or PESs was performed. The 30-day and 1-year clinical outcomes of 102 patients receiving SESs were compared to those of 70 patients receiving PESs. There was no significant difference in baseline demographic, angiographic, and procedural characteristics between the SES and PES treatment groups. There was no statistical difference in major adverse cardiac events at 30 days and at 1 year (hazard ratio [HR] 1.58, 95% confidence interval [CI] 0.77 to 3.23, log-rank p = 0.21). There was also no difference in survival (HR 1.28, 95% CI 0.39 to 4.25, log-rank p = 0.69) or target vessel revascularization (HR 2.54, 95% CI 0.84 to 7.72, log-rank p = 0.09). In conclusion, this multicenter analysis of real-world patients demonstrated that SESs and PESs have similar clinical outcomes when used in SVG intervention.
Lee
Michael S
MS
Division of Cardiology, University of California, Los Angeles Medical Center, Los Angeles, California, USA. mslee@mednet.ucla.edu
Hu
Patrick P
PP
Aragon
Joseph
J
Shah
Atman P
AP
Oyama
Jared
J
Dhoot
Jashdeep
J
Iqbal
Zahid
Z
Jones
Nathaniel
N
Penny
William
W
Tobis
Jonathan
J
Mahmud
Ehtisham
E
French
William
W
D000368:Aged; D002140:California / Q000453:epidemiology; D016009:Chi-Square Distribution; D015897:Comorbidity; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods* / Q000401:mortality; D023903:Coronary Restenosis / Q000401:mortality / Q000517:prevention & control*; D054855:Drug-Eluting Stents; D005260:Female; D006083:Graft Occlusion, Vascular / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D017239:Paclitaxel / Q000008:administration & dosage*; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D020123:Sirolimus / Q000008:administration & dosage*; D015996:Survival Rate; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D017239:Paclitaxel; D020123:Sirolimus