title: Continued benefit from paclitaxel-eluting compared with bare-metal stent implantation in saphenous vein graft lesions during long-term follow-up of the SOS (Stenting of Saphenous Vein Grafts) trial.
abstract: OBJECTIVE
  This study sought to report the long-term outcomes after drug-eluting stent (DES) implantation in saphenous vein graft (SVG) lesions in the SOS (Stenting of Saphenous Vein Grafts) trial.
  
  
  BACKGROUND
  The long-term outcomes after DES implantation in SVGs are poorly studied. Apart from the SOS trial, the only other randomized trial comparing DES with bare-metal stents (BMS) in SVGs reported higher mortality in the DES group at 32 months.
  
  
  METHODS
  In the SOS trial, 80 patients with 112 lesions in 88 SVGs were randomized to a BMS or paclitaxel-eluting stent (PES) and demonstrated improved short-term angiographic and clinical outcomes with PES. Extended clinical follow-up was subsequently obtained.
  
  
  RESULTS
  Mean age was 67 ± 9 years, and all patients were men. The indications for stenting included acute coronary syndrome in 60% and stable angina in 31% of patients. The mean SVG age was 12 ± 6 years. The baseline characteristics of the patients in the 2 study groups were similar. Procedural success was achieved in 77 patients (96%). During a median follow-up of 35 months, compared with patients randomized to BMS, those receiving PES had a lower incidence of myocardial infarction (hazard ratio [HR]: 0.32, p = 0.01), target lesion revascularization (HR: 0.20, p = 0.004), target vessel revascularization (HR: 0.41, p = 0.03), and target vessel failure (HR: 0.34, p = 0.001) as well as a trend toward less definite or probable stent thrombosis (HR: 0.15, p = 0.08). All-cause mortality (HR: 2.04, p = 0.19) and cardiac mortality (HR: 0.62, p = 0.51) did not differ between groups.
  
  
  CONCLUSIONS
  During long-term follow-up, use of PES was associated with significantly better clinical outcomes than BMS in SVG lesions. (Stenting of Saphenous Vein Grafts Trial [SOS]; NCT00247208).
authors.affiliation: Department of Cardiovascular Diseases, Veteran Affairs North Texas Healthcare System, Dallas, Texas, USA. esbrilakis@yahoo.com
authors.forename: Emmanouil S
authors.initials: ES
authors.lastname: Brilakis
authors.forename: Christopher
authors.initials: C
authors.lastname: Lichtenwalter
authors.forename: Abdul-rahman R
authors.initials: AR
authors.lastname: Abdel-karim
authors.forename: James A
authors.initials: JA
authors.lastname: de Lemos
authors.forename: Owen
authors.initials: O
authors.lastname: Obel
authors.forename: Tayo
authors.initials: T
authors.lastname: Addo
authors.forename: Michele
authors.initials: M
authors.lastname: Roesle
authors.forename: Donald
authors.initials: D
authors.lastname: Haagen
authors.forename: Bavana V
authors.initials: BV
authors.lastname: Rangan
authors.forename: Bilal
authors.initials: B
authors.lastname: Saeed
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Bissett
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sachdeva
authors.forename: Vassilios V
authors.initials: VV
authors.lastname: Voudris
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Karyofillis
authors.forename: Biswajit
authors.initials: B
authors.lastname: Kar
authors.forename: James
authors.initials: J
authors.lastname: Rossen
authors.forename: Panayotis
authors.initials: P
authors.lastname: Fasseas
authors.forename: Peter
authors.initials: P
authors.lastname: Berger
authors.forename: Subhash
authors.initials: S
authors.lastname: Banerjee
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality; D054855:Drug-Eluting Stents; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D017239:Paclitaxel / Q000008:administration & dosage*; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D018570:Risk Assessment; D012307:Risk Factors; D012501:Saphenous Vein / Q000637:transplantation*; D016037:Single-Blind Method; D015607:Stents; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
chemical_list: D002317:Cardiovascular Agents; D008670:Metals; D017239:Paclitaxel