title: Comparison of 4.5-Year Outcomes of Bare-Metal and Zotarolimus-Eluting Stents in New York.
abstract: BACKGROUND
  Both bare-metal stents (BMS; the first-generation coronary stent) and zotarolimus-eluting stents (ZES; a second-generation drug-eluting stent [DES]) have been widely utilized to treat coronary heart disease. However, the long-term comparative effectiveness of BMS and ZES remains unclear. The purpose of this study was to evaluate long-term comparative effectiveness of BMS versus ZES.
  
  
  METHODS
  We created a longitudinal database by linking the New York State (NYS) cardiac registries, statewide hospital discharge data, the National Death Index (NDI), and the U.S. Census file (2010) for patients receiving either BMS or ZES during the 2008-2009 period. We examined the rates of all-cause mortality, acute myocardial infarction (AMI), target-lesion PCI (TLPCI), and target-vessel coronary artery bypass graft (TVCABG) surgery for a follow-up period of 4.5 years. A total of 10,443 propensity score matched pairs were compared using the Kaplan-Meier method and Cox proportional hazards regression adjusting for patient risk factors.
  
  
  RESULTS
  We found that patients receiving ZES had a lower rate of 4.5-year mortality (adjusted hazard ratio AHR: 0.68, 95% confidence interval CI: 0.63-0.73), AMI (AHR: 0.89, 95% CI: 0.80-0.98), and TVCABG (AHR: 0.84, 95% CI: 0.71-0.99) but a similar rate of TLPCI (AHR: 1.02, 95% CI: 0.93-1.12). For "off-label" and "high-risk" subgroups, ZES was associated with improved mortality and generally better or non-inferior AMI, TLPCI, and TVCABG outcomes relative to BMS.
  
  
  CONCLUSIONS
  Compared with BMS, ZES was associated with lower long-term mortality, AMI and TVCABG. (J Interven Cardiol 2016;29:265-274).
authors.affiliation: University at Albany-State University of New York, Albany, New York.
authors.forename: Feng
authors.initials: F
authors.lastname: Qian
authors.affiliation: University at Albany-State University of New York, Albany, New York.
authors.forename: Ye
authors.initials: Y
authors.lastname: Zhong
authors.affiliation: University at Albany-State University of New York, Albany, New York.
authors.forename: Pornchanok
authors.initials: P
authors.lastname: Kheocha-On
authors.affiliation: University at Albany-State University of New York, Albany, New York.
authors.forename: Edward L
authors.initials: EL
authors.lastname: Hannan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000601:surgery*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008670:Metals; D008875:Middle Aged; D009518:New York; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D057216:Propensity Score; D016016:Proportional Hazards Models; D012042:Registries; D020123:Sirolimus / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D008670:Metals; C489443:zotarolimus; D020123:Sirolimus