Long-term safety and efficacy of drug-eluting and bare metal stents in saphenous vein grafts.
BACKGROUND
Long-term safety and efficacy data of drug-eluting stents (DESs) in saphenous vein grafts (SVGs) are lacking. This study sought to compare the clinical outcomes of DES versus bare metal stents (BMS) in SVGs.


METHODS
We studied all stent implantations in SVGs in Sweden during 74 months between 2005 and 2011 registered in the Swedish Coronary Angiography and Angioplasty Registry. We evaluated outcome in patients who received DES compared with those who received BMS after adjustments for differences in clinical, vessel, and lesion characteristics.


RESULTS
Mean follow-up time was 3 years and 4 months. A total of 4,576 stents, implanted at 3,063 procedures, were included in the analysis of which 2,499 stents (54.6 %) were BMS and 2,077 (45.4%) were DES. The outcome analysis was based on 190 stent thromboses, 898 restenoses, and 523 deaths. The incidence of stent thrombosis did not differ between groups. When adjusted for baseline characteristics, including a propensity score for receiving DES, the incidence of restenosis was significantly lower with DES as compared with BMS (risk ratio 0.83, 95% CI 0.70-0.97, P = .019). There was a difference in mortality in the crude analysis between DES and BMS, and after multivariable adjustment, this difference remained statistically significant (risk ratio 0.80, CI 0.65-0.99, P = .038).


CONCLUSIONS
The use of DES compared with BMS in SVGs was associated with a significantly lower adjusted incidence of restenosis and death in this large, national, all-encompassing propensity adjusted observational study.
Department of Cardiology, Örebro University Hospital, Sweden. ole.frobert@orebroll.se
Ole
O
Fröbert
Fredrik
F
Scherstén
Stefan K
SK
James
Jörg
J
Carlsson
Bo
B
Lagerqvist
D000368:Aged; D003324:Coronary Artery Disease / Q000601:surgery*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012501:Saphenous Vein / Q000637:transplantation*; D015607:Stents / Q000009:adverse effects; D013997:Time Factors; D014656:Vascular Surgical Procedures / Q000295:instrumentation