title: Choice of Stent for Percutaneous Coronary Intervention of Saphenous Vein Grafts.
abstract: BACKGROUND
  There are limited data on comparison of contemporary drug-eluting stent (DES) platforms, previous generation DES, and bare-metal stents (BMS) for percutaneous coronary intervention in saphenous vein grafts (SVG). We aimed to assess clinical outcomes following percutaneous coronary intervention to SVG in patients receiving bare-metal stents (BMS), first-generation DES, and newer generation DES in a large unselected national data set from the BCIS (British Cardiovascular Intervention Society).
  
  
  RESULTS
  Patients undergoing percutaneous coronary intervention to SVG in the United Kingdom from January 2006 to December 2013 were divided into 3 groups according to stent use: BMS, first-generation DES, and newer generation DES group. Study outcomes included in-hospital major adverse cardiovascular events, 30-day mortality, and 1-year mortality. Patients (n=15 003) underwent percutaneous coronary intervention to SVG in England and Wales during the study period. Of these, 38% received BMS, 15% received first-generation DES, and 47% received second-generation DES. The rates of in-hospital major adverse cardiovascular events were significantly lower in patients treated with second-generation DES (odds ratio, 0.51; 95% confidence interval, 0.38-0.68;P<0.001), but not with first-generation DES, compared with BMS-treated patients. Similarly, 30-day mortality (odds ratio, 0.43; 95% confidence interval, 0.32-0.59;P<0.001) and 1-year mortality (odds ratio, 0.60; 95% confidence interval, 0.51-0.71;P<0.001) were lower in patients treated with second-generation DES, but not with first-generation DES, compared with the patients treated with BMS.
  
  
  CONCLUSIONS
  Patients receiving second-generation DES for the treatment SVG disease have lower rates of in-hospital major adverse cardiovascular events, 30-day mortality, and 1-year mortality, compared with those receiving BMS.
authors.affiliation: From the South Yorkshire Cardiothoracic Centre, Northern General Hospital, Sheffield, United Kingdom (J.I.); Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, United Kingdom (C.S.K., M.A.M.); University Hospital North Staffordshire, United Kingdom (C.S.K., A.L., R.B., M.A.M.); Institute of Population Health (E.K.) and Farr Institute (M.A.M.), University of Manchester, United Kingdom; The James Cook University Hospital, Middlesbrough, United Kingdom (M.A.d.B.); Department of Cardiology, Queen Elizabeth Hospital, Birmingham, United Kingdom (P.F.L.); Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.G., A.Z.); and Department of Cardiology, University Hospital of Wales, Cardiff, United Kingdom (T.K.).
authors.forename: Javaid
authors.initials: J
authors.lastname: Iqbal
authors.affiliation: From the South Yorkshire Cardiothoracic Centre, Northern General Hospital, Sheffield, United Kingdom (J.I.); Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, United Kingdom (C.S.K., M.A.M.); University Hospital North Staffordshire, United Kingdom (C.S.K., A.L., R.B., M.A.M.); Institute of Population Health (E.K.) and Farr Institute (M.A.M.), University of Manchester, United Kingdom; The James Cook University Hospital, Middlesbrough, United Kingdom (M.A.d.B.); Department of Cardiology, Queen Elizabeth Hospital, Birmingham, United Kingdom (P.F.L.); Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.G., A.Z.); and Department of Cardiology, University Hospital of Wales, Cardiff, United Kingdom (T.K.).
authors.forename: Chun Shing
authors.initials: CS
authors.lastname: Kwok
authors.affiliation: From the South Yorkshire Cardiothoracic Centre, Northern General Hospital, Sheffield, United Kingdom (J.I.); Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, United Kingdom (C.S.K., M.A.M.); University Hospital North Staffordshire, United Kingdom (C.S.K., A.L., R.B., M.A.M.); Institute of Population Health (E.K.) and Farr Institute (M.A.M.), University of Manchester, United Kingdom; The James Cook University Hospital, Middlesbrough, United Kingdom (M.A.d.B.); Department of Cardiology, Queen Elizabeth Hospital, Birmingham, United Kingdom (P.F.L.); Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.G., A.Z.); and Department of Cardiology, University Hospital of Wales, Cardiff, United Kingdom (T.K.).
authors.forename: Evangelos
authors.initials: E
authors.lastname: Kontopantelis
authors.affiliation: From the South Yorkshire Cardiothoracic Centre, Northern General Hospital, Sheffield, United Kingdom (J.I.); Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, United Kingdom (C.S.K., M.A.M.); University Hospital North Staffordshire, United Kingdom (C.S.K., A.L., R.B., M.A.M.); Institute of Population Health (E.K.) and Farr Institute (M.A.M.), University of Manchester, United Kingdom; The James Cook University Hospital, Middlesbrough, United Kingdom (M.A.d.B.); Department of Cardiology, Queen Elizabeth Hospital, Birmingham, United Kingdom (P.F.L.); Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.G., A.Z.); and Department of Cardiology, University Hospital of Wales, Cardiff, United Kingdom (T.K.).
authors.forename: Mark A
authors.initials: MA
authors.lastname: de Belder
authors.affiliation: From the South Yorkshire Cardiothoracic Centre, Northern General Hospital, Sheffield, United Kingdom (J.I.); Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, United Kingdom (C.S.K., M.A.M.); University Hospital North Staffordshire, United Kingdom (C.S.K., A.L., R.B., M.A.M.); Institute of Population Health (E.K.) and Farr Institute (M.A.M.), University of Manchester, United Kingdom; The James Cook University Hospital, Middlesbrough, United Kingdom (M.A.d.B.); Department of Cardiology, Queen Elizabeth Hospital, Birmingham, United Kingdom (P.F.L.); Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.G., A.Z.); and Department of Cardiology, University Hospital of Wales, Cardiff, United Kingdom (T.K.).
authors.forename: Peter F
authors.initials: PF
authors.lastname: Ludman
authors.affiliation: From the South Yorkshire Cardiothoracic Centre, Northern General Hospital, Sheffield, United Kingdom (J.I.); Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, United Kingdom (C.S.K., M.A.M.); University Hospital North Staffordshire, United Kingdom (C.S.K., A.L., R.B., M.A.M.); Institute of Population Health (E.K.) and Farr Institute (M.A.M.), University of Manchester, United Kingdom; The James Cook University Hospital, Middlesbrough, United Kingdom (M.A.d.B.); Department of Cardiology, Queen Elizabeth Hospital, Birmingham, United Kingdom (P.F.L.); Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.G., A.Z.); and Department of Cardiology, University Hospital of Wales, Cardiff, United Kingdom (T.K.).
authors.forename: Adrian
authors.initials: A
authors.lastname: Large
authors.affiliation: From the South Yorkshire Cardiothoracic Centre, Northern General Hospital, Sheffield, United Kingdom (J.I.); Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, United Kingdom (C.S.K., M.A.M.); University Hospital North Staffordshire, United Kingdom (C.S.K., A.L., R.B., M.A.M.); Institute of Population Health (E.K.) and Farr Institute (M.A.M.), University of Manchester, United Kingdom; The James Cook University Hospital, Middlesbrough, United Kingdom (M.A.d.B.); Department of Cardiology, Queen Elizabeth Hospital, Birmingham, United Kingdom (P.F.L.); Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.G., A.Z.); and Department of Cardiology, University Hospital of Wales, Cardiff, United Kingdom (T.K.).
authors.forename: Rob
authors.initials: R
authors.lastname: Butler
authors.affiliation: From the South Yorkshire Cardiothoracic Centre, Northern General Hospital, Sheffield, United Kingdom (J.I.); Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, United Kingdom (C.S.K., M.A.M.); University Hospital North Staffordshire, United Kingdom (C.S.K., A.L., R.B., M.A.M.); Institute of Population Health (E.K.) and Farr Institute (M.A.M.), University of Manchester, United Kingdom; The James Cook University Hospital, Middlesbrough, United Kingdom (M.A.d.B.); Department of Cardiology, Queen Elizabeth Hospital, Birmingham, United Kingdom (P.F.L.); Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.G., A.Z.); and Department of Cardiology, University Hospital of Wales, Cardiff, United Kingdom (T.K.).
authors.forename: Amr
authors.initials: A
authors.lastname: Gamal
authors.affiliation: From the South Yorkshire Cardiothoracic Centre, Northern General Hospital, Sheffield, United Kingdom (J.I.); Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, United Kingdom (C.S.K., M.A.M.); University Hospital North Staffordshire, United Kingdom (C.S.K., A.L., R.B., M.A.M.); Institute of Population Health (E.K.) and Farr Institute (M.A.M.), University of Manchester, United Kingdom; The James Cook University Hospital, Middlesbrough, United Kingdom (M.A.d.B.); Department of Cardiology, Queen Elizabeth Hospital, Birmingham, United Kingdom (P.F.L.); Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.G., A.Z.); and Department of Cardiology, University Hospital of Wales, Cardiff, United Kingdom (T.K.).
authors.forename: Tim
authors.initials: T
authors.lastname: Kinnaird
authors.affiliation: From the South Yorkshire Cardiothoracic Centre, Northern General Hospital, Sheffield, United Kingdom (J.I.); Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, United Kingdom (C.S.K., M.A.M.); University Hospital North Staffordshire, United Kingdom (C.S.K., A.L., R.B., M.A.M.); Institute of Population Health (E.K.) and Farr Institute (M.A.M.), University of Manchester, United Kingdom; The James Cook University Hospital, Middlesbrough, United Kingdom (M.A.d.B.); Department of Cardiology, Queen Elizabeth Hospital, Birmingham, United Kingdom (P.F.L.); Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.G., A.Z.); and Department of Cardiology, University Hospital of Wales, Cardiff, United Kingdom (T.K.).
authors.forename: Azfar
authors.initials: A
authors.lastname: Zaman
authors.affiliation: From the South Yorkshire Cardiothoracic Centre, Northern General Hospital, Sheffield, United Kingdom (J.I.); Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, United Kingdom (C.S.K., M.A.M.); University Hospital North Staffordshire, United Kingdom (C.S.K., A.L., R.B., M.A.M.); Institute of Population Health (E.K.) and Farr Institute (M.A.M.), University of Manchester, United Kingdom; The James Cook University Hospital, Middlesbrough, United Kingdom (M.A.d.B.); Department of Cardiology, Queen Elizabeth Hospital, Birmingham, United Kingdom (P.F.L.); Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.G., A.Z.); and Department of Cardiology, University Hospital of Wales, Cardiff, United Kingdom (T.K.). mamasmamas1@yahoo.co.uk.
authors.forename: Mamas A
authors.initials: MA
authors.lastname: Mamas
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D012501:Saphenous Vein / Q000637:transplantation*; D015607:Stents; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology
keywords: cardiovascular diseases; coronary artery bypass; mortality; percutaneous coronary intervention; saphenous vein graft