1. Long-Term Safety and Efficacy of Drug-Eluting Stents
- Author
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Alberto Cremonesi, Enrico Aurier, Aleardo Maresta, Elisabetta Varani, Antonio Manari, Paolo Guastaroba, Gianfranco Percoco, Paolo Magnavacchi, Giancarlo Piovaccari, Alberto Benassi, Roberto Grilli, Francesco Saia, and Antonio Marzocchi
- Subjects
Male ,Drug ,medicine.medical_specialty ,Ticlopidine ,Paclitaxel ,media_common.quotation_subject ,medicine.medical_treatment ,Myocardial Infarction ,Kaplan-Meier Estimate ,Coronary Angiography ,Revascularization ,Coronary Restenosis ,Risk Factors ,Physiology (medical) ,Diabetes Mellitus ,medicine ,Humans ,Prospective Studies ,Registries ,Renal Insufficiency ,Angioplasty, Balloon, Coronary ,Aged ,Proportional Hazards Models ,media_common ,Drug Implants ,Sirolimus ,Aspirin ,business.industry ,Coronary Thrombosis ,Incidence ,Coronary Stenosis ,Stent ,Middle Aged ,medicine.disease ,Combined Modality Therapy ,Coronary Vessels ,Clopidogrel ,Treatment Outcome ,Emergency medicine ,Female ,Stents ,Long term safety ,Medical emergency ,Cardiology and Cardiovascular Medicine ,business ,Platelet Aggregation Inhibitors ,Follow-Up Studies - Abstract
Background— The long-term safety and efficacy of drug-eluting stents (DES) have been questioned recently. Methods and Results— Between July 2002 and June 2005, 10 629 patients undergoing elective percutaneous coronary intervention with either DES (n=3064) or bare-metal stents (BMS, n=7565) were enrolled in a prospective registry comprising 13 hospitals. We assessed the cumulative incidence of major adverse cardiac events (death, acute myocardial infarction, and target-vessel revascularization) and angiographic stent thrombosis during 2-year follow-up. A propensity score analysis to adjust for different baseline clinical, angiographic, and procedural characteristics was performed. The 2-year unadjusted cumulative incidence of major adverse cardiac events was 17.8% in the DES group and 21.0% in the BMS group ( P =0.003 by log-rank test). Angiographic stent thrombosis was 1.0% in the DES group and 0.6% in the BMS group ( P =0.09). After adjustment, the 2-year cumulative incidence of death was 6.8% in the DES group and 7.4% in the BMS group ( P =0.35), whereas the rates were 5.3% in DES and 5.8% in BMS for acute myocardial infarction ( P =0.46), 9.1% in DES and 12.9% in BMS for target-vessel revascularization ( P P Conclusions— In this large real-world population, the beneficial effect of DES in reducing the need for new revascularization compared with BMS extends to 2 years without evidence of a worse safety profile.
- Published
- 2007