Key result
DES for ostial SVG lesions linked to ~70% lower 1-year MACE risk versus BMS.
Why the study?
Ostial saphenous vein graft lesions were excluded from clinical trials comparing drug-eluting stents to bare metal stents, leaving their efficacy uncertain.
Does drug-eluting stent implantation reduce major adverse cardiac events compared to bare metal stents in patients with ostial saphenous vein graft lesions?
Cohort (n=70)
Does drug-eluting stent implantation reduce major adverse cardiac events compared to bare metal stents in patients with ostial saphenous vein graft lesions?
Drug-eluting stents significantly reduce the need for target lesion and target vessel revascularization compared to bare metal stents in ostial saphenous vein graft lesions at 1 year.
Answers are grounded in this paper and cite their sources.
May support DES use for ostial SVG lesions; leaves open need for RCTs to confirm before practice change.
BACKGROUND: Ostial saphenous vein graft (OSVG) lesions were excluded from all the clinical trials demonstrating significantly lower restenosis rates with drug-eluting stents (DES) compared to bare metal stents (BMS). This study aimed to evaluate the efficacy of DES in OSVG lesions by assessing angiographic and 12-month clinical outcomes. METHODS: 70 consecutive patients (70 OSVG lesions) underwent coronary stent implantation between May 2003 and April 2006: 37 lesions received DES and 33 lesions BMS. Endpoints were all cause and cardiovascular mortality, myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), examined separately and as a combined end-point (major adverse cardiac events, MACE). RESULTS: Procedural (94.6% for DES and 87.9% for BMS) and angiographic (100% for DES and 100% for BMS) success did not differ between the two groups. The only in-hospital events were non-Q wave MI (DES 8.1% versus BMS 12.1%, P=0.69). At 30-day follow-up, there were no other events. Overall, at 1-year follow-up, the BMS group had a higher TLR (30.3% versus 5.4%, P=0.015), TVR (33.3% versus 10.8%, P=0.045) and MACE rate (36.4% versus 10.8%, P=0.024) compared to the DES group. CONCLUSIONS: Drug-eluting stent implantation to OSVG lesions achieves better clinical results than BMS but is still associated with a relatively high incidence (10.8%) of revascularization at 1-year follow-up.
No takes yet. Share an insight, caveat, or question.
Kaplan et al. (2008) conducted a cohort in Ostial saphenous vein graft (OSVG) lesions (n=70). Drug-eluting stents (DES) vs. Bare metal stents (BMS) was evaluated on Major adverse cardiac events (MACE) (p=0.024). Drug-eluting stents for ostial saphenous vein graft lesions were associated with a significantly lower 1-year MACE rate compared to bare metal stents (10.8% vs 36.4%; P=0.024).
Synapse has enriched 10 related papers. Consider them for comparative context: