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Updated: Jun 25, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Value of drug-eluting stents in cardiac transplant recipients
Anuj Gupta1, Donna Mancini, Ajay J Kirtane
1Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York, USA.
Insights
Drug-eluting stents (DESs) did not improve survival for transplant allograft vasculopathy (TAV) patients compared to bare-metal stents (BMSs). While DESs reduced restenosis, TAV patients treated with DESs still faced worse survival than controls.
Area of Science:
- Cardiology
- Transplantation Medicine
- Interventional Cardiology
Background:
- Transplant allograft vasculopathy (TAV) is a major cause of late mortality in cardiac transplant recipients.
- The comparative effectiveness of drug-eluting stents (DESs) versus bare-metal stents (BMSs) for TAV-related epicardial stenosis remains unclear.
Purpose of the Study:
- To evaluate the safety and efficacy of DESs compared to BMSs in treating TAV.
- To assess the impact of DESs on survival in cardiac transplant recipients with TAV.
Main Methods:
- Retrospective review of 32 patients treated with DESs for TAV.
- Comparison with a historical cohort of 35 patients treated with BMSs for TAV.
- Analysis of survival data against age- and gender-matched cardiac transplant controls.
Main Results:
- No significant difference in 1-year survival between DES and BMS groups after risk factor adjustment.
- 1-year restenosis rates were 19% for DES and 49% for BMS.
- Patients treated with DESs for TAV exhibited significantly worse survival compared to non-TAV controls.
Conclusions:
- Treatment of TAV with DESs did not alter the disease's natural detrimental course.
- While DESs reduce restenosis, they do not improve overall survival in TAV patients.
- TAV remains a significant predictor of poor survival in cardiac transplant recipients.
Abstract:
Transplant allograft vasculopathy (TAV) was a leading cause of death in cardiac transplant recipients after the first year of transplantation. Whether drug-eluting stents (DESs) performed better than bare-metal stents (BMSs) for the treatment of patients with discrete epicardial stenosis was unknown. The aim was to determine the safety and efficacy of DESs compared with BMSs in the treatment of patients with TAV. Outcomes of 32 patients sequentially treated using DESs for TAV were retrospectively reviewed and compared with a historic cohort of 35 patients treated sequentially with BMSs for TAV. Patients treated with DESs were also compared with age- and gender-matched cardiac transplant controls to determine differences in survival. After adjustment for baseline risk factors, there was no difference in 1-year survival between patients treated with DESs or BMSs for TAV. Restenosis rates at 1 year were 49% in lesions treated using BMSs and 19% in those treated using DESs. Compared with an age- and gender-matched control group of cardiac transplant patients who did not have discrete obstructive epicardial TAV, patients who required treatment with DESs for epicardial obstructive disease had significantly worse survival. In conclusion, treatment of patients with TAV with DESs did not seem to alter the natural deleterious history of this disease process.
