1. Drug-Eluting or Bare-Metal Stents for Coronary Artery Disease.
- Author
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Bønaa, K. H., Mannsverk, J., Wiseth, R., Aaberge, L., Myreng, Y., Nygård, O., Nilsen, D. W., Kløw, N. -E., Uchto, M., Trovik, T., Bendz, B., Stavnes, S., Bjørnerheim, R., Larsen, A. -I., Slette, M., Steigen, T., Jakobsen, O. J., Bleie, Ø., Fossum, E., and Hanssen, T. A.
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CORONARY heart disease treatment , *DRUG-eluting stents , *PERCUTANEOUS coronary intervention , *MYOCARDIAL infarction risk factors , *QUALITY of life , *MYOCARDIAL revascularization , *THROMBOSIS , *CORONARY disease , *LONGITUDINAL method , *MYOCARDIAL infarction , *REOPERATION , *RESEARCH funding , *SURGICAL stents , *TRANSLUMINAL angioplasty , *RAPAMYCIN , *RANDOMIZED controlled trials , *KAPLAN-Meier estimator - Abstract
Background: Limited data are available on the long-term effects of contemporary drug-eluting stents versus contemporary bare-metal stents on rates of death, myocardial infarction, repeat revascularization, and stent thrombosis and on quality of life.Methods: We randomly assigned 9013 patients who had stable or unstable coronary artery disease to undergo percutaneous coronary intervention (PCI) with the implantation of either contemporary drug-eluting stents or bare-metal stents. In the group receiving drug-eluting stents, 96% of the patients received either everolimus- or zotarolimus-eluting stents. The primary outcome was a composite of death from any cause and nonfatal spontaneous myocardial infarction after a median of 5 years of follow-up. Secondary outcomes included repeat revascularization, stent thrombosis, and quality of life.Results: At 6 years, the rates of the primary outcome were 16.6% in the group receiving drug-eluting stents and 17.1% in the group receiving bare-metal stents (hazard ratio, 0.98; 95% confidence interval [CI], 0.88 to 1.09; P=0.66). There were no significant between-group differences in the components of the primary outcome. The 6-year rates of any repeat revascularization were 16.5% in the group receiving drug-eluting stents and 19.8% in the group receiving bare-metal stents (hazard ratio, 0.76; 95% CI, 0.69 to 0.85; P<0.001); the rates of definite stent thrombosis were 0.8% and 1.2%, respectively (P=0.0498). Quality-of-life measures did not differ significantly between the two groups.Conclusions: In patients undergoing PCI, there were no significant differences between those receiving drug-eluting stents and those receiving bare-metal stents in the composite outcome of death from any cause and nonfatal spontaneous myocardial infarction. Rates of repeat revascularization were lower in the group receiving drug-eluting stents. (Funded by the Norwegian Research Council and others; NORSTENT ClinicalTrials.gov number, NCT00811772 .). [ABSTRACT FROM AUTHOR]- Published
- 2016
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