title: Long term follow-up of drug eluting versus bare metal stents in the treatment of saphenous vein graft lesions.
abstract: BACKGROUND
  The safety and effectiveness of drug-eluting stent (DES) compared with bare metal stents (BMS) for the treatment of saphenous vein graft (SVG) disease is controversial, especially because of the lack of long-term follow-up. The aim of this study was to address the late outcome of DES versus BMS for the treatment of SVG lesions.
  
  
  METHODS
  A matched, case-control study included 82 patients in each group. Patients groups were matched by gender, age, clinical presentation, and diabetes. The primary study end point was occurrence of major adverse cardiovascular events (MACE). Secondary end points included death, cardiac death, myocardial infarction (MI), and target vessel revascularization (TVR).
  
  
  RESULTS
  Clinical and angiographic characteristics were similar between the groups. At 6 months, TVR (hazard ratio [HR] 6.12, 95% confidence interval [CI] 1.39 to 26.93, P = 0.05), and MACE (HR 2.54, 95% CI 1.08 to 5.98, P = 0.04) were higher in the BMS group. At 4 years the risks of MI (P = 0.21), TVR (P = 0.99), and MACE (P = 0.21) were similar between both groups. However, the rates of death (HR 2.74, 95% CI 1.11 to 6.74, P = 0.04) and cardiac death (HR 4.26, 95% CI 1.59 to 11.35, P = 0.01) were significantly higher in the BMS group.
  
  
  CONCLUSIONS
  These results suggest that the use of DES compared with BMS in the treatment of SVG lesions reduces TVR and MACE at 6 months of follow-up, a benefit that was lost over the next 3-4 years.
authors.affiliation: Department of Interventional Cardiology, Heart Institute-InCor, University of São Paulo, São Paulo, Brazil.
authors.forename: Luiz F
authors.initials: LF
authors.lastname: Ybarra
authors.forename: Henrique B
authors.initials: HB
authors.lastname: Ribeiro
authors.forename: Antonio H
authors.initials: AH
authors.lastname: Pozetti
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Campos
authors.forename: Rodrigo B
authors.initials: RB
authors.lastname: Esper
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Lemos
authors.forename: Augusto C
authors.initials: AC
authors.lastname: Lopes
authors.forename: Roberto
authors.initials: R
authors.lastname: Kalil-Filho
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Ellis
authors.forename: Expedito E
authors.initials: EE
authors.lastname: Ribeiro
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality; D054855:Drug-Eluting Stents; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D016555:Matched-Pair Analysis; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008670:Metals