title: Recurrent cardiovascular events with paclitaxel-eluting versus bare-metal stents in saphenous vein graft lesions: insights from the SOS (Stenting of Saphenous Vein Grafts) trial.
abstract: The Stenting of Saphenous Vein Grafts (SOS) trial demonstrated a reduction in clinical and angiographic adverse events with paclitaxel-eluting stents (PES) compared to bare-metal stents (BMS) in saphenous vein graft (SVG) lesions, but the rate of recurrent adverse events has not been described.
  
  
  METHODS
  We performed a post hoc, landmark analysis to evaluate the risk of event recurrence following a non-fatal initial event among the SOS trial patients (pts).
  
  
  RESULTS
  During a median follow-up of 35 months, the 80 pts enrolled in SOS experienced a total of 78 major cardiovascular events (MACE): 51 in the BMS group and 27 in PES group. No MACE were found in 28 pts (35%) while 52 pts (65%) had at least one event. The initial event was death in 13 pts (16%). Among the 39 pts whose initial event was not fatal, 12 (31%) had one or more subsequent MACE (50% of which were definitely related to the study SVG). The mean and median number of MACE per patient was significantly higher in patients receiving BMS versus PES (1.3 ± 1.2 and 1 ± 1.26 versus 0.6 ± 0.7 and 1 ± 0.825, p = 0.005 and p = 0.008, respectively). The rate of a second MACE following an initial event was 17% in the PES group and 37% in the BMS group (p = 0.24). Ten of 12 pts with recurrent events had received a BMS (83%).
  
  
  CONCLUSIONS
  Pts undergoing SVG stenting had a high rate of recurrent events after an initial non-fatal event. These events were often related to the target vessel and most occurred in pts who had received a BMS, further supporting the benefit of PES over BMS in SVG lesions.
authors.affiliation: Veteran Affairs North Texas Healthcare System, Dallas, Texas, USA.
authors.forename: Tesfaldet T
authors.initials: TT
authors.lastname: Michael
authors.forename: Abdul-rahman R
authors.initials: AR
authors.lastname: Abdel-karim
authors.forename: Aristotelis
authors.initials: A
authors.lastname: Papayannis
authors.forename: Christopher
authors.initials: C
authors.lastname: Lichtenwalter
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 B
authors.initials: PB
authors.lastname: Berger
authors.forename: Subhash
authors.initials: S
authors.lastname: Banerjee
authors.forename: Emmanouil S
authors.initials: ES
authors.lastname: Brilakis
mesh_terms: D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D017239:Paclitaxel; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012307:Risk Factors; D012501:Saphenous Vein / Q000637:transplantation*
chemical_list: D017239:Paclitaxel