Long-Term Outcomes with First vs Second Generation Drug-Eluting Stents in Saphenous Vein Graft Lesions




Pokala, Nagendra

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BACKGROUND: Compared to bare metal stents, first-generation drug-eluting stents (DES) significantly improved post-procedural outcomes in aortocoronary saphenous vein graft (SVG) lesions, but there is limited information on outcomes after use of second-generation DES. METHODS: We compared the outcomes of patients who received first-generation DES (n=82) with those who received second-generation DES (n=166) in SVG lesions at our institution between 2006 and 2013. Major adverse cardiac events (MACE) were defined as the composite of all-cause death, myocardial infarction, and target vessel revascularization. RESULTS: Mean age was 66.0 years and 97.6% of the patients were men. Mean SVG age was 11.1 ± 0.4 years. First-generation DES were sirolimus-eluting (n=17) and paclitaxel-eluting (n=65) stents. Second-generation DES were everolimus-eluting (n=115) and zotarolimus-eluting (n=51) stents. Median follow-up was 41 months. At 2 years post-procedure, patients with first- and second-generation DES had similar rates of death (20.00% vs. 20.91%, p=0.881), target lesion revascularization (16.13% vs. 20.00%, p=0.541), target vessel revascularization (20.63% vs. 23.16%, p=0.709), myocardial infarction (25.76% vs. 23.00%, p=0.684), and MACE (40.04% vs. 40.87%, p=0.764), respectively. CONCLUSIONS: Outcomes with first and second generation DES in SVGs are similar. Novel stent designs are needed to further improve the clinical outcomes in this challenging lesion subgroup.

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The 52nd Annual Medical Student Research Forum at UT Southwestern Medical Center (Tuesday, February 4, 2014, 3-6 p.m., D1.502)

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Pokala, N., Menon, R. V., Patel, S. M., Christopoulos, G., Kotsia, A. P., Rangan, B. V., . . . Brilakis, E. (2014, February 4). Long-term outcomes with first vs second generation drug eluting stents in saphenous vein graft lesions. Poster session presented at the 52nd Annual Medical Student Research Forum, Dallas, TX. Retrieved from https://hdl.handle.net/2152.5/1688

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