Get access

A comparative analysis of major clinical outcomes using drug-eluting stents versus bare-metal stents in a large consecutive patient cohort

Authors

  • Tamir Bental MD,

    Corresponding author
    1. Cardiology Department, Rabin Medical Center (Beilinson and Golda/Hasharon Hospitals), Petach-Tikva, and “Sackler” Faculty of Medicine, Tel-Aviv University, Israel
    • Cardiology Department, Rabin Medical Center (Beilinson and Golda/Hasharon Hospitals), Petach-Tikva, and “Sackler” Faculty of Medicine, Tel-Aviv University, Israel
    Search for more papers by this author
  • Abid Assali MD,

    1. Cardiology Department, Rabin Medical Center (Beilinson and Golda/Hasharon Hospitals), Petach-Tikva, and “Sackler” Faculty of Medicine, Tel-Aviv University, Israel
    Search for more papers by this author
  • Hana Vaknin-Assa MD,

    1. Cardiology Department, Rabin Medical Center (Beilinson and Golda/Hasharon Hospitals), Petach-Tikva, and “Sackler” Faculty of Medicine, Tel-Aviv University, Israel
    Search for more papers by this author
  • Eli I. Lev MD,

    1. Cardiology Department, Rabin Medical Center (Beilinson and Golda/Hasharon Hospitals), Petach-Tikva, and “Sackler” Faculty of Medicine, Tel-Aviv University, Israel
    Search for more papers by this author
  • David Brosh MD,

    1. Cardiology Department, Rabin Medical Center (Beilinson and Golda/Hasharon Hospitals), Petach-Tikva, and “Sackler” Faculty of Medicine, Tel-Aviv University, Israel
    Search for more papers by this author
  • Shmuel Fuchs MD,

    1. Cardiology Department, Rabin Medical Center (Beilinson and Golda/Hasharon Hospitals), Petach-Tikva, and “Sackler” Faculty of Medicine, Tel-Aviv University, Israel
    Search for more papers by this author
  • Alexander Battler MD,

    1. Cardiology Department, Rabin Medical Center (Beilinson and Golda/Hasharon Hospitals), Petach-Tikva, and “Sackler” Faculty of Medicine, Tel-Aviv University, Israel
    Search for more papers by this author
  • Ran Kornowski MD

    1. Cardiology Department, Rabin Medical Center (Beilinson and Golda/Hasharon Hospitals), Petach-Tikva, and “Sackler” Faculty of Medicine, Tel-Aviv University, Israel
    Search for more papers by this author

  • Conflict of interest: Nothing to Report.

Abstract

Objectives: To ascertain the long-term safety, efficacy, and pattern of use of drug-eluting stents (DES) in routine clinical practice. Methods: We analyzed a registry of 6,583 consecutive patients undergoing percutaneous coronary intervention (PCI), of whom 2,633 were treated using DES (DES group) and 3,950 were treated using bare-metal stents (BMS group). Propensity score was used for stratified analysis of outcomes and for matching. Outcomes were total mortality, myocardial infarction (MI), repeat target vessel revascularization (TVR) rates, and risk-adjusted event-free survival. Results: Follow-up time was 6 months to 5.18 years (mean: 3 years). Patients in the DES group were more likely to be diabetic and had use of longer or more stents, treatment of more lesions and of more proximal main vessels. After propensity score matching, the cumulative mortality was 12.85% in the DES group versus 14.14% in the BMS group (P = 0.001). Use of DES reduced the occurrence of MI (5.17% vs.5.83%, P = 0.046), of clinically driven TVR (9.76% vs. 12.28%, P < 0.001) and of the composite endpoint of death/MI/TVR (23.38% vs. 26.07%; P < 0.001). Conclusions: Our risk-adjusted event-free survival analysis indicates a prognostic benefit for DES utilization that sustains up to 5 years following PCI. © 2010 Wiley-Liss, Inc.

Ancillary