Choice of Stent Evaluated for PCI of Saphenous Vein Grafts
April 17, 2017—An evaluation of the choice of stent for percutaneous coronary intervention (PCI) of saphenous vein grafts (SVGs) was published by Javaid Iqbal, MD, et al in Circulation: Cardiovascular Interventions. The investigators aimed to assess clinical outcomes after PCI of SVGs in patients receiving bare-metal stents (BMSs), first-generation drug-eluting stents (DESs), and newer-generation DESs in a large unselected national data set from the British Cardiovascular Intervention Society.
As summarized in Circulation: Cardiovascular Interventions, patients undergoing PCI to SVGs in the United Kingdom from January 2006 to December 2013 were divided into three groups according to stent use: BMSs, first-generation DESs, and newer-generation DESs. Study outcomes included in-hospital major adverse cardiovascular events, 30-day mortality, and 1-year mortality. Patients (N = 15,003) underwent PCI to SVGs in England and Wales during the study period. Of these, 38% received BMSs, 15% received first-generation DESs, and 47% received second-generation DESs.
The investigators reported that the rates of in-hospital major adverse cardiovascular events were significantly lower in patients treated with second-generation DESs (odds ratio [OR], 0.51; 95% confidence interval [CI], 0.38–0.68; P < .001), but not with first-generation DESs, compared with BMS-treated patients. Similarly, 30-day mortality (OR, 0.43; 95% CI, 0.32–0.59; P < .001) and 1-year mortality (OR, 0.6; 95% CI, 0.51–0.71; P < .001) were lower in patients treated with second-generation DESs, but not with first-generation DESs, compared with the patients treated with BMSs.
Patients receiving second-generation DESs for the treatment SVG disease have lower rates of in-hospital major adverse cardiovascular events, 30-day mortality, and 1-year mortality, compared with those receiving BMSs, concluded the investigators in Circulation: Cardiovascular Interventions.