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Ferromagnetic Bare Metal Stent for Endothelial Cell Capture and Retention
Published on: September 18, 2015
Long-term outcome after drug-eluting stent implantation in comparison with bare metal stents: a single centre
Ioannis Tentzeris1, Rudolf Jarai, Serdar Farhan
13rd Department of Medicine, Cardiology and Emergency Medicine, Wilhelminen Hospital, Montleartstrasse 37, Vienna, Austria. i_tentzeris@gmx.net
Insights
Drug-eluting stents (DES) show a long-term clinical benefit over bare-metal stents (BMS) in real-world settings. DES significantly reduced all-cause mortality and target vessel revascularization compared to BMS.
Area of Science:
- Cardiology
- Interventional Cardiology
- Biomaterials
Background:
- Comparison of drug-eluting stents (DES) and bare-metal stents (BMS) in percutaneous coronary intervention (PCI).
- Evaluation of clinical outcomes in a real-world patient cohort.
Purpose of the Study:
- To assess the comparative effectiveness of DES versus BMS.
- To analyze the impact on all-cause mortality and target vessel revascularization (TVR).
Main Methods:
- Prospective registry of 1,490 patients undergoing PCI (2003-2006).
- Retrospective division into DES (n=457) and BMS (n=1,033) groups.
- Propensity score analysis to mitigate selection bias.
Main Results:
- DES group showed lower rates of combined all-cause death or TVR (12.9% vs. 21.3%, p=0.015).
- Mortality was significantly lower in the DES group (5.7% vs. 12.3%, p=0.025).
- TVR rates were similar between groups (7.2% vs. 9.6%, p=0.1).
Conclusions:
- Drug-eluting stents demonstrate a long-term clinical advantage over bare-metal stents.
- DES are safe and effective, offering superior outcomes in real-world PCI.
- Findings support the use of DES for improved patient management.
Background:
The aim of our study was to evaluate the effect of drug-eluting stents (DES) compared with bare-metal stents (BMS) on all-cause mortality and target vessel revascularization (TVR) in a "real-world" clinical setting.
Methods And Results:
One thousand four hundred and ninety consecutive patients, who underwent PCI, were included in a prospective registry from January 2003 until December 2006. Patients were divided retrospectively into two groups: those who received a DES and those who received a BMS. The primary combined endpoint all-cause mortality or TVR and the individual endpoints death and TVR were evaluated during a mean follow-up period of 24.56 ± 12.5 months (range 6-52 months). In total 1,033 patients (69.3%) received BMS, while 457 patients (30.7%) received DES. With respect to clinical characteristics, significant differences between groups were found for age, hyperlipidemia, diabetes mellitus, heart failure, previous cerebral insult and presence of acute coronary syndrome (ACS) during intervention. Propensity score analysis was performed in attempt to eliminate this selection bias. With respect to the combined endpoint all-cause death or TVR, 12.9% of patients with DES and 21.3% with BMS (p = 0.015) had an event during the follow-up. 12.3% of patients with BMS but only 5.7% with DES died during the follow-up (p = 0.025). Thirty-three patients (7.2%) of the DES group and 99 patients (9.6%) of the BMS group (p = 0.1) needed TVR.
Conclusion:
Our results obtained in a "real-world" clinical setting exhibit a clinical long-term benefit for DES compared with BMS and underline the safety and efficacy of DES over BMS.