Two‐year outcomes after percutaneous coronary intervention with drug‐eluting stents or bare‐metal stents in elderly patients with coronary artery disease

• Published in: Catheterization and cardiovascular interventions 2021-04, Vol.97 (5), p.E607-E613
• Main Authors: Lafont, Alexandre, Sinnaeve, Peter R, Cuisset, Thomas, Cook, Stéphane, Sideris, Giorgios, Kedev, Sasko, Carrie, Didier, Hovasse, Thomas, Garot, Philippe, El Mahmoud, Rami, Spaulding, Christian, Helft, Gérard, Diaz Fernandez, José F, Brugaletta, Salvatore, Pinar‐Bermudez, Eduardo, Ferre, Josepa Mauri, Commeau, Philippe, Teiger, Emmanuel, Bogaerts, Kris, Sabate, Manel, Morice, Marie Claude, Varenne, Olivier
• Format: Article
• Language: English
• Subjects: Angioplasty; bare metal stents; Cardiovascular disease; Cerebral infarction; Coronary artery; Drug delivery; drug eluting stents; elderly patients; Heart diseases; Human health and pathology; Implants; Ischemia; Life Sciences; Mortality; Myocardial infarction; PCI; short DAPT; Stents; Thrombosis
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.29159

Objectives Report the results at 2 years of the patients included in the SENIOR trial. Background Patients above 75 years of age represent a fast‐growing population in the cathlab. In the SENIOR trial, patients treated by percutaneous coronary intervention (PCI) with drug eluting stent (DES) and a short duration of P2Y12 inhibitor (1 and 6 months for stable and unstable coronary syndromes, respectively) compared with bare metal stents (BMS) was associated with a 29% reduction in the rate of all‐cause mortality, myocardial infarction (MI), stroke, and ischaemia‐driven target lesion revascularization (ID‐TLR) at 1 year. The results at 2 years are reported here. Methods and Results We randomly assigned 1,200 patients (596[50%] to the DES group and 604[50%] to the BMS group). At 2 years, the composite endpoint of all‐cause mortality, MI, stroke and ID‐TLR had occurred in 116 (20%) patients in the DES group and 131 (22%) patients in the BMS group (RR 0.90 [95%CI 0.72–1.13], p = .37). IDTLR occurred in 14 (2%) patients in the DES group and 41 (7%) patients in the BMS group (RR 0.35 [95%CI 0.16–0.60], p = .0002). Major bleedings (BARC 3–5) occurred in 27(5%) patients in both groups (RR 1.00, [95%CI 0.58–1.75], p = .99). Stent thrombosis rates were low and similar between DES and BMS (0.8 vs 1.3%, (RR 0.52 [95%CI 0.01–1.95], p = .27). Conclusion Among elderly PCI patients, a strategy combining a DES together with a short duration of DAPT is associated with a reduction in revascularization up to 2 years compared with BMS with very few late events and without any increased in bleeding complications or stent thrombosis.