Safety and efficacy of drug-eluting stents versus bare-metal stents in saphenous vein grafts lesions: a meta-analysis

Sánchez‐Recalde, Ángel; Valero, Santiago Jiménez; Moreno, Raúl; Barreales, Laura; Lozano, Íñigo; Galeote, Guillermo; Reyes, Roberto Martín; Calvo, Luís; López-Sendón, José

doi:10.4244/eijv6i1a22

Cited by 35 publications

(22 citation statements)

References 30 publications

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“…All showed reduction in target vessel revascularization with DES. One meta-analysis also revealed reduction in MI with DES (8), and 2 suggested reduction in mortality (10,11) with DES. However, the results of these meta-analyses and systematic reviews were driven by the retrospective, uncontrolled studies that provided most of the analyzed data.…”

Section: Discussionmentioning

confidence: 92%

Continued Benefit From Paclitaxel-Eluting Compared With Bare-Metal Stent Implantation in Saphenous Vein Graft Lesions During Long-Term Follow-Up of the SOS (Stenting of Saphenous Vein Grafts) Trial

Brilakis¹,

Lichtenwalter

Abdel-Karim

et al. 2011

JACC: Cardiovascular Interventions

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Section: Discussionmentioning

confidence: 92%

Continued Benefit From Paclitaxel-Eluting Compared With Bare-Metal Stent Implantation in Saphenous Vein Graft Lesions During Long-Term Follow-Up of the SOS (Stenting of Saphenous Vein Grafts) Trial

Brilakis¹,

Lichtenwalter

Abdel-Karim

et al. 2011

JACC: Cardiovascular Interventions

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“…Differences in cardiac death were not recorded when taking into account only randomised trials 12 . However, conflicting results were observed among the few studies investigating outcomes beyond one year.…”

Section: Discussionmentioning

confidence: 99%

Long-term comparison of everolimus-eluting stents with sirolimus- and paclitaxel-eluting stents for percutaneous coronary intervention of saphenous vein grafts

Taniwaki

Räber²,

Magro³

et al. 2014

EuroIntervention

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Aims: Newer-generation everolimus-eluting stents (EES) have been shown to improve clinical outcomes compared with early-generation sirolimus-eluting (SES) and paclitaxel-eluting stents (PES) in patients undergoing percutaneous coronary intervention (PCI). Whether this benefit is maintained among patients with saphenous vein graft (SVG) disease remains controversial. Methods and results:We assessed cumulative incidence rates (CIR) per 100 patient years after inverse probability of treatment weighting to compare clinical outcomes. The pre-specified primary endpoint was the composite of cardiac death, myocardial infarction (MI), and target vessel revascularisation (TVR). Out of 12,339 consecutively treated patients, 288 patients (5.7%) underwent PCI of at least one SVG lesion with EES (n=127), SES (n=103) or PES (n=58). Up to four years, CIR of the primary endpoint were 58.7 for EES, 45.2 for SES and 45.6 for PES with similar adjusted risks between groups (EES vs. SES; HR 0.94, 95% CI: 0.55-1.60, EES vs. PES; HR 1.07, 95% CI: 0.60-1.91). Adjusted risks showed no significant differences between stent types for cardiac death, MI and TVR.Conclusions: Among patients undergoing PCI for SVG lesions, newer-generation EES have similar safety and efficacy to early-generation SES and PES during long-term follow-up to four years. KEYWORDS

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“…Por outro lado, a análise de estudos observacionais apontou redução significativa de morte, IM e RLA entre os pacientes tratados com stents farmacológicos. Na meta-análise conduzida por Sanchez-Recalde et al 22 , os pacientes que receberam stents farmacológicos apresentaram taxas significativamente menores de RLA e morte.…”

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Stents farmacológicos vs. stents não-farmacológicos no tratamento de enxertos de veia safena

Collet¹,

Costa²,

Sousa³

et al. 2011

Rev. Bras. Cardiol. Invasiva

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RESUMOIntrodução: Embora os stents farmacológicos tenham reduzido acentuadamente a reestenose e a necessidade de novas revascularizações na maioria dos cenários clínicos e angiográficos, o benefício desses dispositivos no tratamento de lesões em enxertos de veia safena (EVS) ainda precisa ser definido. O objetivo deste estudo foi comparar a incidência de eventos cardíacos adversos maiores (ECAM) entre stents farmacológicos e stents não-farmacológicos em lesões em EVS em pacientes não-selecionados. Métodos: Foram incluídos pacientes tratados em dois hospitais terciários entre maio de 2006 e janeiro de 2009. O objetivo primá-rio foi comparar a incidência de ECAM entre stents farmacológicos e stents não-farmacológicos durante a hospitalização e no seguimento a longo prazo. Resultados: No total, foram incluídos, consecutivamente, 308 pacientes, divididos de acordo com o tipo de stent implantado (209 com stents farmacológicos e 99 com stents não-farmacológicos). A média de idade do grupo foi de 68 anos e a dos EVS, de 10,9 anos. Na fase intra-hospitalar, houve tendência para maior incidência de ECAM no grupo que recebeu stents farmacológicos (12% vs. 5,1%; P = 0,06). Até 24 meses, a incidência de ECAM foi equivalente nos dois grupos (17,2% no grupo stents farmacológicos vs. 18,2% no grupo stents não-farmacológicos; P = 0,87). Trombose do stent definitiva/provável foi semelhante em ambos os grupos (2,3% no grupo stents farmacológicos vs. 2% no grupo stents não-farmacológicos; P = 0,94). Conclusões: Nesta série de pacientes complexos do mundo real, não houve preocupação com a segurança a longo prazo relacionada ao uso de stents farmacológicos no tratamento de lesões em EVS, com incidências similares de morte cardíaca/infarto do miocárdio/trombose do stent em ambos os grupos. DESCRITORES:Stents. Stents farmacológicos. Veia safena. ABSTRACT Drug-Eluting Stents vs. Bare-Metal Stents in Saphenous Vein Graft LesionsBackground: Although drug-eluting stents have markedly reduced restenosis and the need for repeat lesion revascularization in the vast majority of clinical and angiographic scenarios, the benefit of these devices for the treatment of saphenous-vein graft (SVG) lesions is yet to be defined. The aim of our study was to compare the rate of major adverse clinical events (MACE) between drug-eluting stents and bare-metal stents in SVG lesions in non-selected patients. Methods: Patients treated in two tertiary hospitals betweenMay 2006 and January 2009 were included. The primary objective was to compare the incidence of MACE between drug-eluting stents and bare-metal stents during hospitalization and in the long-term follow-up. Results: Overall, 308 patients were consecutively enrolled and divided according to the type of stent deployed (209 with drug-eluting stents and 99 with bare-metal stents). Mean age was 68 years and SVG mean age was 10.9 years. In the in-hospital phase there was a trend towards higher MACE in the drug-eluting stents group (12% vs. 5.1%; P = 0.06). The incidence of MACE in up to 24 months was equi...

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Safety and efficacy of drug-eluting stents versus bare-metal stents in saphenous vein grafts lesions: a meta-analysis

Cited by 35 publications

References 30 publications

Continued Benefit From Paclitaxel-Eluting Compared With Bare-Metal Stent Implantation in Saphenous Vein Graft Lesions During Long-Term Follow-Up of the SOS (Stenting of Saphenous Vein Grafts) Trial

Continued Benefit From Paclitaxel-Eluting Compared With Bare-Metal Stent Implantation in Saphenous Vein Graft Lesions During Long-Term Follow-Up of the SOS (Stenting of Saphenous Vein Grafts) Trial

Long-term comparison of everolimus-eluting stents with sirolimus- and paclitaxel-eluting stents for percutaneous coronary intervention of saphenous vein grafts

Stents farmacológicos vs. stents não-farmacológicos no tratamento de enxertos de veia safena

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