Drug-Eluting Stents Better for Saphenous Vein Graft Lesions

Better clinical, angiographic outcomes with drug-eluting versus bare-metal stents one year later

MONDAY, Aug. 29 (HealthDay News) -- Drug-eluting stents are better than bare-metal stents for reducing the risk of adverse events for patients undergoing percutaneous coronary intervention for de-novo saphenous vein graft lesions, according to a study published online Aug. 28 in The Lancet, to coincide with the European Society of Cardiology Congress held Aug. 27 to 31 in Paris, France.

Julinda Mehilli, M.D., from the Deutsches Herzzentrum in Germany, and colleagues compared the clinical outcomes of drug-eluting stents versus bare-metal stents in patients with de-novo aortocoronary saphenous vein graft lesions. Out of a total of 610 patients, 303 and 307 were randomly assigned to receive either one of three types of drug-eluting stents or bare-metal stents, respectively. Patients were not masked to allocation; however, the investigators were masked to treatment allocation. Combined incidence of death, myocardial infarction, and target lesion revascularization at one year was the primary end point.

The investigators found that there was a significantly reduced incidence of the primary endpoint with drug-eluting stents compared with bare-metal stents (44 versus 66 patients; hazard ratio [HR], 0.64). Compared to bare-metal stents, drug-eluting stents also significantly reduced the target lesion revascularization rate (19 versus 37 patients; HR, 0.49). No significant differences were found between the two groups for all-cause mortality, myocardial infarction, and definite or probable stent thrombosis.

"Use of drug-eluting stents for treatment of de-novo venous graft lesions was associated with better clinical and angiographic outcomes up to one year after the procedure compared with bare-metal stents," the authors write.

One of the study authors disclosed financial ties with Abbott, and Terumo, and another with Abbott, Biosensors, Biotronik, Cordis, and Medtronic.

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