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Long-term safety and efficacy of drug-eluting and bare metal stents in saphenous vein grafts
Örebro University Hospital. Department of Cardiology.ORCID iD: 0000-0002-5846-345X
Department of Cardiology, Skåne University Hospital, Lund, Sweden.
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Department of Cardiology, Kalmar Hospital, Kalmar, Sweden.
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2012 (English)In: American Heart Journal, ISSN 0002-8703, E-ISSN 1097-6744, Vol. 164, no 1, p. 87-93Article in journal (Refereed) Published
Abstract [en]

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. (Am Heart J 2012;164:87-93.)

Place, publisher, year, edition, pages
Elsevier, 2012. Vol. 164, no 1, p. 87-93
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:oru:diva-58669DOI: 10.1016/j.ahj.2012.04.012ISI: 000306366900013PubMedID: 22795287Scopus ID: 2-s2.0-84863637947OAI: oai:DiVA.org:oru-58669DiVA, id: diva2:1121602
Funder
Swedish Heart Lung FoundationSwedish Association of Local Authorities and RegionsSwedish National Board of Health and Welfare
Note

Funding Agency:

Swedish Medical Products Agency (all Stockholm, Sweden)

Available from: 2017-07-12 Created: 2017-07-12 Last updated: 2024-01-16Bibliographically approved

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Fröbert, Ole

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