A Comparison of Event Rates for Patients Receiving Sirolimus Drug-Eluting vs. Bare Metal Stents

Abstract

Background: Two types of stents are used to revascularize occluded coronary arteries. Bare metal stents prevent elastic recoil and negative remodeling of the vessel wall following balloon catheter stretch. Drug-eluting stents release medications that prevent the development of neointimal hyperplasia. Drug-eluting stents, however, have been purported to increase the risk of acute stent thrombosis, potentially placing patients at higher risk for major adverse cardiac events in the 12 months following stent implementation. Objective: To determine whether patients receiving a drug-eluting stent experienced a higher rate of major adverse cardiac events at one year after stent placement than did patients who received a bare metal stent, and to determine the impact of antiplatelet therapy on major adverse cardiac event rates. Methods: We conducted a retrospective chart review of patients receiving either a sirolimus-eluting or bare metal stent at the Veterans Affairs North Texas Health Care System between July and December 2003. Results: Sixty-eight patients were included in the study. There was one episode of acute stent thrombosis and no statistically significant difference in major adverse cardiac event rates at 1 year after stent placement between the groups. Clopidogrel therapy was originally prescribed for an average of 3.9 months in the drug-eluting stent group and 1 month in the bare metal stent group. The actual duration of clopidogrel therapy differed significantly from the original prescribed duration for both groups, mainly due to renewal of clopidogrel prescriptions by noncardiology practitioners. Conclusions: Patients who received a sirolimus-eluting stent did not experience an increase in major adverse cardiac events compared with patients receiving a bare metal stent.