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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

Five-year outcomes in patients with chronic total coronary occlusion treated with drug-eluting vs bare-metal stents:

Francesco De Felice1, Rosario Fiorilli, Antonio Parma

  • 1UO Cardiologia Interventistica Azienda Ospedaliera S. Camillo Forlanini, Roma, Italy. f.defelice@lycos.com

The Canadian Journal of Cardiology
|December 26, 2012
PubMed

Insights

Drug-eluting stents (DESs) significantly reduce major adverse cardiac events (MACE), target vessel failure (TVF), and target lesion revascularization (TLR) compared to bare-metal stents (BMS) in chronic total coronary occlusion (CTO) patients over 5 years.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Biomaterials Science

Background:

  • Limited long-term data on drug-eluting stents (DESs) in chronic total coronary occlusion (CTO).
  • Need to compare DES vs. bare-metal stents (BMS) for long-term safety and effectiveness in CTO.
  • Previous studies focused on shorter follow-up periods.

Purpose of the Study:

  • To evaluate the 5-year clinical outcomes of DES vs. BMS in patients with successfully treated CTO.
  • To compare the incidence of major adverse cardiac events (MACE), target vessel failure (TVF), and target lesion revascularization (TLR) between DES and BMS groups.
  • To identify predictors of MACE at 5-year follow-up.

Main Methods:

  • Retrospective comparison of 156 patients treated with DES versus 159 historical controls treated with BMS.
  • Primary endpoint: freedom from MACE (death, myocardial infarction, TLR).
  • Secondary endpoints: freedom from TVF and TLR at 5 years.

Main Results:

  • DES group showed significantly superior event-free survival from MACE (84% vs. 69%), TVF (71% vs. 84%), and TLR (77% vs. 92%) compared to BMS at 5 years.
  • BMS vs. DES was an independent predictor of MACE (HR=3.37).
  • Stent thrombosis rates were similar between groups (7% DES vs. 4% BMS).

Conclusions:

  • Drug-eluting stents (DESs) are superior to bare-metal stents (BMSs) in reducing MACE, TVF, and TLR in CTO patients at 5-year follow-up.
  • DESs should be the preferred treatment strategy for CTO.
  • Long-term outcomes favor DES implantation in complex coronary artery disease.
Abstract

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