Key result
Cobalt chromium stents were associated with a higher 6-month rate of major adverse cardiac events compared to drug-eluting stents, driven by increased target lesion revascularization.
Why the study?
Does drug-eluting stent use reduce major adverse cardiac events compared to cobalt chromium stents in patients undergoing percutaneous coronary intervention?
Observational (n=735)
No
Does drug-eluting stent use reduce major adverse cardiac events compared to cobalt chromium stents in patients undergoing percutaneous coronary intervention?
Answers are grounded in this paper and cite their sources.
Supports preferring drug-eluting over cobalt chromium stents to potentially reduce MACE in PCI; leaves open confirmation in randomized trials.
Cobalt chromium stents (CCS) are seldom compared to drug-eluting stents (DES) for coronary intervention in published clinical trials. We evaluated the daily usage patterns of CCS in comparison to DES unconstrained by eligibility criteria. We compared consecutive patients (n = 303) with de novo lesions treated exclusively with a CCS to 432 patients treated exclusively with a DES. Patients in the CCS group were older, frequently had heart failure, renal failure, prior coronary balloon angioplasty, prior stroke, more comorbidities, and more multivessel disease than the DES group. The DES group had longer and more type C and left anterior descending (LAD) coronary artery lesions. The in-hospital major adverse cardiac events (MACE; death, myocardial infarction, stroke and target lesion revascularization (TLR)) were similar. At 6 months, the cumulative rate of MACE was 12.9% in the CCS group and 5.6% in the DES group (P < 0.001), and this was driven by TLR. The rates of stent thrombosis were similar in CCS (0.9%) and DES (1.0%) patients. In conclusion, the CCS were used in clinically higher risk patients, while DES were used in more severely diseased coronary arteries. Drug-eluting stent use resulted in lower rates of clinically driven repeat revascularization with similar rates of death, MI, stroke, and stent thrombosis.
No takes yet. Share an insight, caveat, or question.
Youssef et al. (2010) conducted an observational in Coronary artery disease (n=735). Cobalt chromium stents vs. Drug-eluting stents was evaluated on Major adverse cardiac events (MACE) at 6 months (p=<0.001). Cobalt chromium stents were associated with a higher 6-month rate of major adverse cardiac events compared to drug-eluting stents, driven by increased target lesion revascularization.
Synapse has enriched 10 related papers. Consider them for comparative context: