The clinical outcome of restricting drug-eluting stents to patients at highest risk of restenosis

Probal Roy, Brian P. Yan, A. Bower, Andrew E. Ajani, Jeffrey Lefkovitz, Roderick J. Warren

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: To assess the clinical outcomes of patients where drug eluting stents (DES) were restricted to those at highest risks of restenosis, we compared three different strategies for stent implantation: bare metal stents (BMS) only, DES only and a group where DES use was restricted (RES). Method and results: Initial comparison was made between BMS only (279 patients, 316 lesions) and DES only (272 patients, 302 lesions). The endpoints of death, non-fatal myocardial infarction and target lesion revascularisation (TLR) [MACE] were assessed at 12 months. The incidence of MACE in the BMS only and DES only groups were 14% and 7% (p=0.002) and TLR was 8% and 1% (p<0.0001). Comparison was then made between these results and a third group where DES was restricted to patients at highest risk of restenosis. The restricted group (RES) comprised 249 patients (271 lesions) of which 53% received DES. RES remained significantly better than BMS, MACE (14% vs. 8%, p=0.02) and TLR (8% vs. 3%, p=0.02). When RES was compared with DES only, there was no significant difference in MACE (8% vs. 7% p=0.42), but there was a significantly lower TLR rate in the DES only group (1% vs. 3% p=0.04). Conclusions: The overall incidence of events in patients where DES use was restricted to 53% of patients remains low and this may be an acceptable treatment strategy to reduce costs.
Original languageEnglish
Pages (from-to)238-243
Number of pages6
JournalEuroIntervention
Volume2
Issue number2
Publication statusPublished - 2006
Externally publishedYes

Fingerprint

Dive into the research topics of 'The clinical outcome of restricting drug-eluting stents to patients at highest risk of restenosis'. Together they form a unique fingerprint.

Cite this