A comparative analysis of major clinical outcomes using drug-eluting stents versus bare-metal stents in a large consecutive patient cohort

Tamir Bental*, Abid Assali, Hana Vaknin-Assa, Eli I. Lev, David Brosh, Shmuel Fuchs, Alexander Battler, Ran Kornowski

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To ascertain the long-term safety, efficacy, and pattern of use of drug-eluting stents (DES) in routine clinical practice. Methods: We analyzed a registry of 6,583 consecutive patients undergoing percutaneous coronary intervention (PCI), of whom 2,633 were treated using DES (DES group) and 3,950 were treated using bare-metal stents (BMS group). Propensity score was used for stratified analysis of outcomes and for matching. Outcomes were total mortality, myocardial infarction (MI), repeat target vessel revascularization (TVR) rates, and risk-adjusted event-free survival. Results: Follow-up time was 6 months to 5.18 years (mean: 3 years). Patients in the DES group were more likely to be diabetic and had use of longer or more stents, treatment of more lesions and of more proximal main vessels. After propensity score matching, the cumulative mortality was 12.85% in the DES group versus 14.14% in the BMS group (P = 0.001). Use of DES reduced the occurrence of MI (5.17% vs.5.83%, P = 0.046), of clinically driven TVR (9.76% vs. 12.28%, P < 0.001) and of the composite endpoint of death/MI/TVR (23.38% vs. 26.07%; P < 0.001). Conclusions: Our risk-adjusted event-free survival analysis indicates a prognostic benefit for DES utilization that sustains up to 5 years following PCI.

Original languageEnglish
Pages (from-to)374-380
Number of pages7
JournalCatheterization and Cardiovascular Interventions
Volume76
Issue number3
DOIs
StatePublished - 1 Sep 2010

Keywords

  • Angioplasty
  • Bare metal stents
  • Drug-eluting stents

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