Late outcomes of drug-eluting versus bare meta stents in saphenous vein grafts: Propensity score analysis

To compare late outcomes with the routine use of drug-eluting stents (DES) compared with bare-metal stents (BMS) during percutaneous intervention (PCI) of saphenous vein grafts (SVGs). Background: Safety concerns >1 year from stent implantation have been raised about DES used for PCI of SVGs in a small randomized clinical trial. However, there are few studies comparing late outcomes of DES and BMS in routine clinical practice. Methods: Clinical outcomes (nonfatal MI, cardiac mortality) were assessed in 74 consecutive patients who received BMS and 74 consecutive propensity score matched patients that received DES for PCI of SVGs. Clinical follow-up was censored at 2 years +/- 30 days for both stent groups. Results: At 2 years, the hazard ratio for DES compared with BMS for PCI of SVGs for target vessel revascularization was 0.54 (0.21-1.36), nonfatal MI or cardiac death was 0.68 (0.27-1.68), cardiac mortality 1.19 (0.32-4.45), and stent thrombosis 0.49 (0.09-2.66). Similar outcomes were observed stratified by propensity score quintile. Conclusions: The routine clinical use of DES for PCI of SVGs was associated with a safety profile that was similar to that of bare metal stents with a clear trend toward a less frequent need for reinterventions. (C) 2008 Wiley-Liss, Inc.