Drug-Eluting Stents Versus Bare-Metal Stents in Saphenous Vein Graft Intervention

Nileshkumar J. Patel, Chirag Bavishi, Varunsiri Atti, Avnish Tripathi, Nikhil Nalluri, Mauricio G Cohen, Annapoorna S. Kini, Samin K. Sharma, George Dangas, Deepak L. Bhatt

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Abstract

Background Percutaneous coronary intervention with drug-eluting stents (DES) has been increasingly used for revascularization of saphenous vein graft stenosis without strong clinical evidence favoring their use. Randomized controlled trials comparing DES versus bare-metal stents (BMS) in saphenous vein graft-percutaneous coronary intervention have been inconclusive. Methods and Results We performed a comprehensive literature search through May 15, 2018, for all eligible studies comparing DES versus BMS in patients with saphenous vein graft stenosis in PubMed, EMBASE, SCOPUS, Google Scholar, and ClinicalTrials.gov. Clinical outcomes included all-cause mortality, cardiovascular mortality, major adverse cardiovascular events, myocardial infarction, stent thrombosis, and target vessel revascularization. Six randomized controlled trials were eligible and included 1582 patients, of whom 797 received DES and 785 received BMS. The follow-up period ranged from 18 months to 60 months. There was no statistically significant difference between DES and BMS for all-cause mortality (risk ratio [RR],1.11; 95% CI, 0.0.77-1.62; P=0.57), cardiovascular mortality (RR, 1.00; 95% CI, 0.64-1.57; P=0.99), major adverse cardiovascular events (RR, 0.83; 95% CI, 0.63-1.10; P=20), target vessel revascularization (RR, 0.73; 95% CI, 0.48-1.11; P=0.14), myocardial infarction (RR, 0.74; 95% CI, 0.48-1.16; P=0.19), or stent thrombosis (RR, 1.06; 95% CI, 0.42-2.65; P=0.90). Conclusions In patients undergoing percutaneous coronary intervention for saphenous vein graft lesions, our results showed that there was no significant difference between DES and BMS for mortality, major adverse cardiovascular events, target vessel revascularization, myocardial infarction, or stent thrombosis.

Original languageEnglish (US)
Pages (from-to)e007045
JournalCirculation. Cardiovascular interventions
Volume11
Issue number11
DOIs
StatePublished - Nov 1 2018

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Keywords

  • bare metal stents
  • drug-eluting stents
  • percutaneous coronary intervention
  • randomized controlled trial
  • saphenous vein graft

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Patel, N. J., Bavishi, C., Atti, V., Tripathi, A., Nalluri, N., Cohen, M. G., Kini, A. S., Sharma, S. K., Dangas, G., & Bhatt, D. L. (2018). Drug-Eluting Stents Versus Bare-Metal Stents in Saphenous Vein Graft Intervention. Circulation. Cardiovascular interventions, 11(11), e007045. https://doi.org/10.1161/CIRCINTERVENTIONS.118.007045