Long-Term Outcomes with Drug-Eluting Stents versus Bare-Metal Stents in Sweden  

Oleh:

Lagerqvist, Bo ; James, Stefan K. ; Stenestrand, Ulf ; Lindback, Johan ; Nilsson, Tage ; Wallentin, Lars

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 356 no. 10 (Mar. 2007), page 1009.

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2007.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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BACKGROUND Recent reports have indicated that there may be an increased risk oflate stent thrOi bosis with the use of drug-eluting stents, as compared with bare-metal stents. METHODS We evaluated 6033 patients treated with drug-eluting stents and 13,738 patients tre. ed with bare-metal stents in 2003 and 2004, using data from the Swedish Corona Angiography and Angioplasty Registry. The outcome analysis covering a period up to 3 years was based on 1424 deaths and 2463 myocardial infarctions and w. adjusted for differences in baseline characteristics. RESULTS The two study groups did not differ significantly in the composite of death ani myocardial infarction during 3 years of follow-up. At 6 months, there was a trend to ward a lower unadjusted event rate in patients with drug-eluting stents than it those with bare-metal stents, with 13.4 fewer such events per 1000 patients. How ever, after 6 months, patients with drug-eluting stents had a significantly highel event rate, with 12.7 more events per 1000 patients per year (adjusted relative risk, 1.20; 95% confidence interval [CI], 1.05 to 1.37). At 3 years, mortality was significantly higher in patients with drug-eluting stents (adjusted relative risk, 1.18; 95% cr, 1.04 to 1.35), and from 6 months to 3 years, the adjusted relative risk for death in this group was 1.32 (95% cr, 1.11 to 1.57). CONCLUSIONS Drug-eluting stents were associated with an increased rate of death, as compared with bare-metal stents. This trend appeared after 6 months, when the risk of death was 0.5 percentage point higher and a composite of death or myocardial infarction was 0.5 to 1.0 percentage point higher per year. The long-term safety of drug-eluting stents needs to be ascertained in large, randomized trials.

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