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Early beneficial effects of drug-eluting stents in vein grafts wane during long term follow-up

, : Early beneficial effects of drug-eluting stents in vein grafts wane during long term follow-up.

The aim of the study was to compare outcomes of drug-eluting stents (DES) versus bare-metal stents (BMS) in saphenous vein graft (SVG) interventions in a case control study with a long-term follow-up.Safety and efficacy of DES in SVG interventions are still controversial. We performed a multicenter registry assessing clinical outcomes with DES vs. BMS. We included 311 patients (239 men, age 68 8 years) who underwent percutaneous coronary interventions (PCI) of SVG lesions with DES (n = 138) or BMS (n = 173) with a 2-year follow-up. The two groups were similar for age, sex, main risk factors, incidence of diabetes, use of IIb/IIIa antagonists, use of aspiration devices or filters, number of stents, and total stent length. Overall, at 9 months follow-up incidence of major adverse cardiac events (MACE) and target vessel revascularization (TVR) were significantly lower in the DES group compared with the BMS group (1.9% vs. 22.%, P = .14 and 8.7% vs. 19.1% in DES and BMS respectively, P = .15), while there was no significant difference in incidence of myocardial infarction (5.1% vs. 5.2%, P = .96) or death (2.2% vs. 4%, respectively, P = .54). However, at 24-month follow-up incidence of MACE was 29.7% in the DES group and 37.% in BMS group (P = .29); incidence of TVR (23.2% vs. 28.9% P = .39), myocardial infarction (9.4% vs. 9.2%), death (7.2% vs. 6.9%) were also similar in the two groups. Although DES appear safe, our findings suggest that the early benefit of DES in SVG may rapidly wane during long-term follow-up.


DOI: 10.1002/ccd.23468

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