Coronary artery diseaseComparison of Drug-Eluting Versus Bare Metal Stents on Later Frequency of Acute Myocardial Infarction and Death
Section snippets
Methods
Patients at our institution who underwent percutaneous coronary intervention from April 2002 to April 2005 were included in the study. All 1,164 patients who underwent percutaneous coronary intervention between April 2002 and April 2003 received BMSs and served as the control group. The study group consisted of 1,285 consecutive patients who received DESs after these stents were fully available (February 2004) and had replaced BMSs as routine stents of choice (≥90% utilization). Patients were
Results
Baseline clinical characteristics of the 2 groups were similar (Table 1). Acute coronary syndromes were present overall in 72% of patients (p = 0.24, BMS vs DES); 41% of the BMS group and 37% of the DES group (p = 0.08) had an AMI within 7 days before their index percutaneous coronary intervention. Lesion and procedural details are listed in Table 2. Procedural success was >99% for the 2 groups (p >0.99). Single lesions were treated in 67.4% of the BMS group and 65.5% of the DES group (p =
Discussion
In this large, contemporary percutaneous coronary intervention experience of unselected, consecutive patients, we observed a significantly lower risk adjusted incidence of AMI and death at 9 months after DES versus BMS implantation. The benefit of DESs appeared to extend across a wide range of patient and lesion characteristics, including patients who would not have been included in previous RCTs, i.e., those with AMI within 7 days before their index procedure and those with multiple lesions.
Acknowledgment
We gratefully acknowledge Tammy Davis for manuscript preparation and Aruna Joel, BS, RN, Sabrina Smith, BS, RN, and Robin Taylor, BS, RN, for data collection and database entry.
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This study was supported by a grant from Cordis Corporation, Miami Lakes, Florida, and a fellowship from Boston Scientific Corporation, Natick, Massachusetts.