Two-Year Follow-Up of Outcomes of Second-Generation Everolimus-Eluting Stents Versus First-Generation Drug-Eluting Stents for Stenosis of Saphenous Vein Grafts Used as Aortocoronary Conduits

• Published in: The American journal of cardiology 2013-07, Vol.112 (1), p.61-67
• Main Authors: Kitabata, Hironori, MD, PhD, Loh, Joshua P., MBBS, Pendyala, Lakshmana K., MD, Badr, Salem, MD, Dvir, Danny, MD, Barbash, Israel M., MD, Minha, Sa'ar, MD, Torguson, Rebecca, MPH, Chen, Fang, MS, PhD, Satler, Lowell F., MD, Suddath, William O., MD, Kent, Kenneth M., MD, PhD, Pichard, Augusto D., MD, Waksman, Ron, MD
• Format: Article
• Language: English
• Subjects: Aged; Biomarkers - blood; Cardiology; Cardiovascular; Coronary Stenosis - drug therapy; Drug therapy; Drug-Eluting Stents; Electrocardiography; Everolimus; Female; Follow-Up Studies; Graft Occlusion, Vascular - drug therapy; Heart attacks; Humans; Immunosuppressive Agents - therapeutic use; Male; Percutaneous Coronary Intervention; Proportional Hazards Models; Retrospective Studies; Saphenous Vein - transplantation; Sirolimus - analogs & derivatives; Sirolimus - therapeutic use; Stents; Treatment Outcome
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2013.02.055

Second-generation everolimus-eluting stents (EESs) have demonstrated superiority in efficacy and safety compared with first-generation drug-eluting stents (DESs) in the treatment of native coronary artery lesions. The present study evaluated and compared the safety and efficacy of EESs and first-generation DESs in saphenous vein graft lesions. The EES group consisted of 88 patients with 96 lesions, and the first-generation DES group consisted of 243 patients with 317 lesions (sirolimus-eluting stents, n = 212; paclitaxel-eluting stents, n = 105). The end points included target lesion revascularization, target vessel revascularization, major adverse cardiovascular events (composite of all-cause death, myocardial infarction, and target vessel revascularization), and definite stent thrombosis at 2 years. The groups had similar baseline characteristics and graft ages (128.1 ± 77.5 vs 132.4 ± 90.8 months, p = 0.686). The EES group had more type C lesions and less embolic protection device use. The peak postprocedure values of creatinine kinase-MB and troponin I were similar between the 2 groups. Overall, major adverse cardiovascular events occurred in 18.2% of EES patients and 35.0% of first-generation DES patients (p = 0.003), mainly driven by a lower target vessel revascularization rate (6.8% vs 24.5%, p