Drug-eluting stents vs bare metal stents for the treatment of large coronary vessels

Quizhpe, Arturo; Feres, Fausto; Costa, José de Ribamar; Abizaid, Alexandre; Maldonado, Galo; Costa, Ricardo; Abizaid, Andréa S.; Cano, Manuel; Moreira, Adriana; Staico, Rodolfo; Mattos, Luiz Alberto; Tanajura, Luiz Fernando; Chaves, Áurea J.; Centemero, Marinella; Sousa, Amanda; Sousa, J. Eduardo

doi:10.1016/j.ahj.2007.04.027

Cited by 29 publications

(18 citation statements)

References 21 publications

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“…Our findings are consistent with results from randomised studies and other large registries which found little or no benefit of DES in large coronary vessels [5,[8][9][10][20][21][22]. In the TAXUS-IV and V trials, benefit of DES was limited to vessels ≤ 3 mm [9,10].…”

Section: Discussionsupporting

confidence: 94%

Are drug-eluting stents indicated in large coronary arteries? Insights from a multi-centre percutaneous coronary intervention registry

Yan

Ajani

New

et al. 2008

International Journal of Cardiology

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Section: Discussionsupporting

confidence: 94%

Are drug-eluting stents indicated in large coronary arteries? Insights from a multi-centre percutaneous coronary intervention registry

Yan

Ajani

New

et al. 2008

International Journal of Cardiology

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“…Similar to previous studies [31, 32], the present analysis did not show any benefit of DES on outcome in large native vessel lesions. However, non-fatal MI rate was somewhat elevated in DES-treated patients with native large vessel interventions which might reflect an elevated rate of acute thrombotic stent occlusions, but this difference was small.…”

Section: Discussionsupporting

confidence: 79%

Drug-Eluting Stents Compared with Bare Metal Stents Improve Late Outcome after Saphenous Vein Graft but Not after Large Native Vessel Interventions

et al. 2008

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Objectives: To define long-term efficacy of different stent types in saphenous vein graft (SVG) interventions. Methods: In BASKET (Basel Stent Cost Effectiveness Trial), major adverse cardiac events (MACE), i.e. cardiac death, myocardial infarction and symptom-driven target vessel revascularization (TVR) were assessed after 18 months comparing drug-eluting stents (DES) versus bare metal stents (BMS), and SVG and large native vessels (≧3.0 mm). Results: Large vessel interventions were performed in 605 patients. Patients with SVG interventions (n = 47, 8%) were older and had more often hypertension, prior myocardial infarction, prior revascularization and multivessel disease and less frequent ST-elevation myocardial infarction than patients with large native vessel interventions (n = 558, 92%). Stent number and length were higher in SVG than in large native vessel interventions. Baseline characteristics were similar for DES and BMS. In SVG stenting, long-term outcome was better in DES- than in BMS-treated patients (MACE 21 vs. 62%, p = 0.007, mainly due to TVR 18 vs. 46%, p = 0.045), but for large native vessel stenting, no significant difference was noted (MACE: 13 vs. 16%, p = 0.40). Conclusions: Among patients with SVG disease, treatment with DES resulted in a better long-term outcome than treatment with BMS. In contrast, no DES benefit was found in similarly sized native vessels regarding MACE.

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“…3,8 -11 Steinberg et al 12 reported that patients treated with ≥3.5 mm DES and BMS had similar low incidence of MACE and target-lesion revascularization (TLR) and TVR in both groups, with no superiority of DES over BMS in this lesion. Quizhpe et al 13 showed excellent 1-year clinical outcomes after large vessel (>3 mm) PCI between DES and BMS. However, the efficacy of different DESs in large vessel diameter with single lesion has not been reported.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Angiographic Outcomes of Drug‐Eluting Stents in Patients With Large Vessel and Single Coronary Artery Lesion

Kim

Seol

et al. 2010

Clinical Cardiology

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Background: The aim of this study was to evaluate and compare the clinical and angiographic outcomes of 3 drug-eluting stents (DES) in patients with large vessel diameter and single coronary artery lesions. Hypothesis: The efficacy of 3 DESs may be similar. Methods: A total of 411 consecutive patients who visited 3 university hospitals from June 2004 to December 2007 and had a single coronary lesion which was treated with the use of a DES that was 3.5 mm in diameter were enrolled in this study. Patients were divided into 3 stent groups: Paclitaxel-eluting stent (PES, n = 105), Sirolimus-eluting stent (SES, n = 259), and Zotarolimus-eluting stent (ZES, n = 47). The study end point was a composite of major adverse cardiac events (MACE) including cardiac death, myocardial infarction (MI), and ischemia-driven target-vessel revascularization (TVR) for 12 months. Results: Baseline characteristics were not different. Late loss was higher in the ZES group than the other stents (0.5 ± 0.4 mm in SES vs 0.3 ± 0.5 mm in PES, 0.7 ± 0.5 mm in ZES, P = 0.001). The total MACE-free survival rate was not significantly different between the SES group and the PES group (98.8% in SES vs 97.1% in PES, P = 0.252) or the PES group and the ZES group (97.1% in PES vs 93.6% in ZES, P = 0.301). However, the SES group showed a significantly better MACE-free survival rate compared with the ZES group (98.8% in SES vs 93.6% in ZES, P = 0.018). Conclusions: Clinical and angiographic outcomes of DES in a large vessel diameter and single coronary artery is excellent and SES appears to show better angiographic and clinical outcomes than ZES. IntroductionDrug-eluting stents (DES) have shown great efficacy in the reduction of restenosis compared with bare-metal stents (BMS). 1 However, the advent of safety and cost concerns shakes the firm position of DESs in a wide range of coronary lesions and patient subsets. The benefits of DESs were confined to lesions <3.0 mm. 2 Although there were several randomized studies and other large registries comparing DES and BMS, 2 -5 no data was reported comparing the different DESs.We seek to evaluate and compare the clinical and angiographic outcomes of 3 different DESs in patients with large vessel diameter and single coronary artery lesion.

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Drug-eluting stents vs bare metal stents for the treatment of large coronary vessels

Cited by 29 publications

References 21 publications

Are drug-eluting stents indicated in large coronary arteries? Insights from a multi-centre percutaneous coronary intervention registry

Are drug-eluting stents indicated in large coronary arteries? Insights from a multi-centre percutaneous coronary intervention registry

Drug-Eluting Stents Compared with Bare Metal Stents Improve Late Outcome after Saphenous Vein Graft but Not after Large Native Vessel Interventions

Clinical and Angiographic Outcomes of Drug‐Eluting Stents in Patients With Large Vessel and Single Coronary Artery Lesion

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