Comparison of Effectiveness of Bare Metal Stents Versus Drug-Eluting Stents in Large (≥3.5 mm) Coronary Arteries

Daniel H. Steinberg, Sundeep Mishra, Aamir Javaid, Tina L Pinto Slottow, Ashesh N. Buch, Probal Roy, Teruo Okabe, Kimberly A. Smith, Rebecca Torguson, Zhenyi Xue, Augusto D. Pichard, Lowell F. Satler, Kenneth M. Kent, William O. Suddath, Ron Waksman*

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    53 Citations (Scopus)

    Abstract

    Drug-eluting stents (DESs) are superior to bare metal stents (BMSs) in decreasing restenosis rates across a wide range of patient and lesion subsets. However, widespread utilization of DESs raises concerns with regard to risks of prolonged dual antiplatelet therapy, the potential for late adverse events such as late thrombosis, and cost. Vessel diameter and lesion length have been previously identified as predictors for restenosis for DESs and BMSs. This study compared the clinical outcomes of DESs versus BMSs in large coronary arteries (≥3.5 mm). A cohort of 233 patients who underwent single-vessel angioplasty with DES implantation in large vessels was compared with 233 propensity-matched patients who received BMSs in vessels with similar reference vessel diameters. Clinical outcomes at 30 days, 6 months, and 1 year were compared between groups. Baseline clinical and procedural characteristics were similar. Target lesion revascularization and target vessel revascularization rates and the incidence of major adverse cardiac events were low and comparable between the 2 groups at all follow-up intervals. At 1 year, the primary outcome occurred in 8.5% of patients with DESs and 7.7% of patients with BMSs (p = 0.80). There were no episodes of subacute stent thrombosis or late thrombosis in either group. In conclusion, implantation of DESs in large coronary arteries confers no additional benefit compared with BMSs, and the 2 approaches are associated with equally favorable clinical outcomes at 1 year.

    Original languageEnglish
    Pages (from-to)599-602
    Number of pages4
    JournalAmerican Journal of Cardiology
    Volume99
    Issue number5
    DOIs
    Publication statusPublished - 1 Mar 2007

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