A Randomized Controlled Trial of a Paclitaxel-Eluting Stent Versus a Similar Bare-Metal Stent in Saphenous Vein Graft Lesions The SOS (Stenting Of Saphenous Vein Grafts) Trial

被引：158

作者：

Brilakis, Emmanouil S. ^{[1
,2
]}

Lichtenwalter, Christopher ^{[1
,2
]}

de Lemos, James A. ^{[1
,2
]}

Roesle, Michele ^{[1
]}

Obel, Owen ^{[1
,2
]}

Haagen, Donald ^{[1
]}

Saeed, Bilal ^{[3
]}

Gadiparthi, Chiranjeevi ^{[1
,2
]}

Bissett, Joseph K. ^{[4
,5
]}

Sachdeva, Rajesh ^{[4
,5
]}

Voudris, Vassilios V. ^{[6
]}

Karyofillis, Panagiotis ^{[6
]}

Kar, Biswajit ^{[7
]}

Rossen, James ^{[8
]}

Fasseas, Panayotis ^{[9
]}

Berger, Peter ^{[10
]}

Banerjee, Subhash ^{[1
,2
]}

机构：

[1] Vet Affairs N Texas Healtchcare Syst, Dallas, TX USA

[2] Univ Texas SW Med Ctr Dallas, Dallas, TX 75390 USA

[3] Univ Toledo, Dept Internal Med, Toledo, OH 43606 USA

[4] Cent Arkansas Vet Hlthcare Syst, Little Rock, AR USA

[5] Univ Arkansas Med Sci, Little Rock, AR USA

[6] Onassis Cariac Surg Ctr, Athens, Greece

[7] Michael E DeBakey VA Med Ctr, Houston, TX USA

[8] Iowa City Vet Affairs Med Ctr, Iowa City, IA USA

[9] Wheaton Franciscan Med Grp, Racine, WI USA

[10] Weis Ctr Res, Geisinger Clin, Danville, PA 17822 USA

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2009年 / 53卷 / 11期

关键词：

bare-metal stents; coronary artery bypass graft surgery; drug-eluting stents; outcomes; percutaneous coronary intervention; saphenous vein grafts; FOLLOW-UP; OUTCOMES; IMPLANTATION;

D O I：

10.1016/j.jacc.2008.11.029

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives The aim of this study was to compare the frequency of angiographic restenosis and clinical events between a paclitaxel-eluting stent (PES) and a similar bare-metal stent (BMS) in saphenous vein graft (SVG) lesions. Background There are conflicting and mostly retrospective data on outcomes after drug-eluting stent implantation in SVGs. Methods Patients requiring SVG lesion stenting were randomized to BMS or PES. The primary study end point was binary in-segment restenosis at 12-month follow-up quantitative coronary angiography. Secondary end points included death, myocardial infarction, ischemia-driven target vessel and lesion revascularization, and target vessel failure. Results Eighty patients with 112 lesions in 88 SVGs were randomized to a BMS (39 patients, 43 grafts, 55 lesions) or PES (41 patients, 45 grafts, 57 lesions). Binary angiographic restenosis occurred in 51% of the BMS-treated lesions versus 9% of the PES-treated lesions (relative risk: 0.18; 95% confidence interval [CI]: 0.07 to 0.48, p < 0.0001). During a median follow-up of 1.5 years the PES patients had less target lesion revascularization (28% vs. 5%, hazard ratio: 0.38; 95% CI: 0.15 to 0.74, p = 0.003) and target vessel failure (46% vs. 22%, hazard ratio: 0.65; 95% CI: 0.42 to 0.96, p = 0.03), a trend toward less target vessel revascularization (31% vs. 15%, hazard ratio: 0.66; 95% CI: 0.39 to 1.05, p = 0.08) and myocardial infarction (31% vs. 15%, hazard ratio: 0.67; 95% CI: 0.40 to 1.08, p = 0.10), and similar mortality (5% vs. 12%, hazard ratio: 1.56; 95% CI: 0.72 to 4.11, p = 0.27). Conclusions In SVG lesions, PES are associated with lower rates of angiographic restenosis and target vessel failure than BMS. (The SOS [Stenting of Saphenous Vein Grafts] Randomized-Controlled Trial; NCT00247208) (J Am Coll Cardiol 2009; 53: 919-28) (C) 2009 by the American College of Cardiology Foundation

引用

页码：919 / 928

页数：10

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