title: Thin strut bare metal stents in patients with atrial fibrillation: Is there still a need for BMS?
abstract: OBJECTIVE
  This observational study assessed the 9-month clinical outcomes in an « all comers » population with a focus on patients with atrial fibrillation (AF) after thin strut bare metal stenting.
  
  
  BACKGROUND
  Drug eluting stent (DES) implantation is the treatment of choice for coronary artery disease (CAD) leaving only marginal indications for the use of bare metal stents (BMS). However, selected treatment populations with DES contraindications such as patients who cannot sustain 6-12 months of dual antiplatelet therapy (DAPT) remain candidates for BMS implantations.
  
  
  METHODS
  Thin strut bare metal stenting in a priori defined subgroups were investigated in a non-randomized, international, multicenter «all comers» observational study. Primary endpoint was the 9-month TLR rate whereas secondary endpoints included the 9-month MACE and procedural success rates.
  
  
  RESULTS
  A total of 783 patients of whom 98 patients had AF underwent BMS implantation. Patient age was 70.4 ± 12.8 years. Cardiovascular risk factors in the overall population were male gender (78.2%, 612/783), diabetes (25.2%, 197/783), hypertension (64.1%, 502/783), cardiogenic shock (4.9%, 38/783) and end stage renal disease (4.9%, 38/783). In-hospital MACE was 4.1% (30/783) in the overall population. The 9-month TLR rate was 4.5% (29/645) in the non-AF group and 3.3% (3/90) in the AF group (P = 0.613). At 9 months, the MACE rate in the AF-group and non-AF group was not significantly different either (10.7%, 69/645 vs. 6.7%, 6/90; P = 0.237). Accumulated stroke rates were 0.3% (2/645) in the non-AF subgroup at baseline and 1.1% (1/90) in the AF subgroup (P = 0.264).
  
  
  CONCLUSIONS
  Bare metal stenting in AF patients delivered acceptably low TLR and MACE rates while having the benefit of a significantly shorter DAPT duration in a DES dominated clinical practice. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Klinik für Kardiologie, Angiologie und Pneumologie, Klinikum Esslingen, Esslingen, Germany. m.leschke@klinikum-esslingen.de.
authors.forename: Matthias
authors.initials: M
authors.lastname: Leschke
authors.affiliation: Medical Scientific Affairs B. Braun Vascular Systems, Berlin, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Waliszewski
authors.affiliation: Cardiologie Interventionelle, Clinique Du Millénaire, Grenoble, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Pons
authors.affiliation: Cardiologie et Rythmologie interventionnelle, Centre Hospitalier De Valence, France.
authors.forename: Stanislas
authors.initials: S
authors.lastname: Champin
authors.affiliation: Pôle Cardiologie vasculaire, Cardiologie, Centre Hospitalier Sainte Musse, France.
authors.forename: Lyassine
authors.initials: L
authors.lastname: Nait Saidi
authors.affiliation: Cardiology, Pantai Hospital Ayer Keroh, Malacca, Malaysia.
authors.forename: Tay
authors.initials: T
authors.lastname: Mok Heang
authors.affiliation: Cardiology, Pusat Perubatan UKM, Kuala Lumpur, Malaysia.
authors.forename: Oteh
authors.initials: O
authors.lastname: Maskon
authors.affiliation: Cardiology, Pusat Perubatan Universiti Malaya, Kuala Lumpur, Malaysia.
authors.forename: Wan
authors.initials: W
authors.lastname: Azman Bin Wan Ahmad
authors.affiliation: Medical Scientific Affairs B. Braun Vascular Systems, Berlin, Germany.
authors.forename: Denny
authors.initials: D
authors.lastname: Herberger
authors.affiliation: Cardiologie interventionnelle, électrophysiologie, Clinique Saint-Pierre Perpignan, France.
authors.forename: Marc-Eric
authors.initials: ME
authors.lastname: Moulichon
authors.affiliation: Cardiologie, Hôpital Albert Schweitzer, Colmar, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Rischner
authors.affiliation: Cardio-Vasculaire, Clinique Convert, Bourg En Bresse, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Robin
authors.affiliation: Département Cardiologie et Maladies Vasculaire, Centre Hospitalier Universitaire Montpellier, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Leclercq
authors.affiliation: Cardiologie - Pathologie cardio vasculaire, Hôpital Privé Beauregard, Marseille, France.
authors.forename: Jean-Pascal
authors.initials: JP
authors.lastname: Peyre
authors.affiliation: Cardiologie, Groupe Hospitalier Mutualiste, Grenoble, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Faurie
authors.affiliation: Klinik für Kardiologie, Angiologie und Pneumologie, Klinikum Esslingen, Esslingen, Germany.
authors.forename: André
authors.initials: A
authors.lastname: Schneider
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage; D001208:Asia; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D004359:Drug Therapy, Combination; D005060:Europe; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000295:instrumentation* / Q000401:mortality; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011474:Prosthesis Design; D012307:Risk Factors; D015607:Stents; D020521:Stroke / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D008670:Metals; D010975:Platelet Aggregation Inhibitors
keywords: MACE; TLR; all comers observational study; atrial fibrillation; bare metal stent