Improved Outcomes Seen With Drug-Eluting Stents

Result in lower mortality, less MI and target vessel revascularization than bare-metal stents

THURSDAY, Aug. 26 (HealthDay News) -- Drug-eluting stents (DES) in percutaneous coronary intervention are associated with improved long-term outcomes, with a benefit that continues for up to five years following the intervention, according to research published in the Sept. 1 issue of Catheterization & Cardiovascular Interventions.

Tamir Bental, M.D., of Tel-Aviv University in Israel, and colleagues analyzed data from 2,633 patients undergoing percutaneous coronary intervention who received DES and 3,950 undergoing the procedure who received bare-metal stents (BMS). The individuals were matched using propensity score.

The researchers found that over a mean three years of follow-up (six months to 5.18 years), cumulative mortality was 12.85 percent in the DES group versus 14.14 percent in the BMS group, after propensity score matching (P = 0.001). Myocardial infarction (MI) occurred in 5.17 and 5.83 percent of the respective groups, clinically driven repeat target vessel revascularization (TVR) occurred in 9.76 and 12.28 percent, and the composite end point of death, MI, and TVR occurred in 23.38 and 26.07 percent. DES recipients were more likely to have diabetes and have longer or more stents.

"When used in a selected population, with preferential treatment of diabetics and proximal main vessels, with the ability to reliably achieve a more complete revascularization, use of DES could confer a sustained survival advantage with a number needed to treat of 26, as well as a sustained benefit in the combined occurrence of death, nonfatal MI, and TVR, with a number needed to treat of 14," the authors conclude.

Abstract
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