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Drug-Eluting or Bare-Metal Stents for Coronary Artery Disease.
- Source :
-
New England Journal of Medicine . 9/29/2016, Vol. 375 Issue 13, p1242-1252. 11p. - Publication Year :
- 2016
-
Abstract
- <bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>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]
- Subjects :
- *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
Subjects
Details
- Language :
- English
- ISSN :
- 00284793
- Volume :
- 375
- Issue :
- 13
- Database :
- Academic Search Index
- Journal :
- New England Journal of Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 118366347
- Full Text :
- https://doi.org/10.1056/NEJMoa1607991