title: A comparative analysis of major clinical outcomes using drug-eluting stents versus bare-metal stents in a large consecutive patient cohort.
abstract: OBJECTIVE
  To ascertain the long-term safety, efficacy, and pattern of use of drug-eluting stents (DES) in routine clinical practice.
  
  
  METHODS
  We analyzed a registry of 6,583 consecutive patients undergoing percutaneous coronary intervention (PCI), of whom 2,633 were treated using DES (DES group) and 3,950 were treated using bare-metal stents (BMS group). Propensity score was used for stratified analysis of outcomes and for matching. Outcomes were total mortality, myocardial infarction (MI), repeat target vessel revascularization (TVR) rates, and risk-adjusted event-free survival.
  
  
  RESULTS
  Follow-up time was 6 months to 5.18 years (mean: 3 years). Patients in the DES group were more likely to be diabetic and had use of longer or more stents, treatment of more lesions and of more proximal main vessels. After propensity score matching, the cumulative mortality was 12.85% in the DES group versus 14.14% in the BMS group (P = 0.001). Use of DES reduced the occurrence of MI (5.17% vs.5.83%, P = 0.046), of clinically driven TVR (9.76% vs. 12.28%, P < 0.001) and of the composite endpoint of death/MI/TVR (23.38% vs. 26.07%; P < 0.001).
  
  
  CONCLUSIONS
  Our risk-adjusted event-free survival analysis indicates a prognostic benefit for DES utilization that sustains up to 5 years following PCI.
authors.affiliation: Cardiology Department, Rabin Medical Center, Tel-Aviv University, Israel. tamir_b@zahav.net.il
authors.forename: Tamir
authors.initials: T
authors.lastname: Bental
authors.forename: Abid
authors.initials: A
authors.lastname: Assali
authors.forename: Hana
authors.initials: H
authors.lastname: Vaknin-Assa
authors.forename: Eli I
authors.initials: EI
authors.lastname: Lev
authors.forename: David
authors.initials: D
authors.lastname: Brosh
authors.forename: Shmuel
authors.initials: S
authors.lastname: Fuchs
authors.forename: Alexander
authors.initials: A
authors.lastname: Battler
authors.forename: Ran
authors.initials: R
authors.lastname: Kornowski
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D015331:Cohort Studies; D018572:Disease-Free Survival; D054855:Drug-Eluting Stents / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007557:Israel; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D010818:Practice Patterns, Physicians'; D057216:Propensity Score; D011474:Prosthesis Design; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008670:Metals