Comparison of Long-Term Results of Drug-Eluting Stent and Bare Metal Stent Implantation in Heart Transplant Recipients With Coronary Artery Disease

Abstract

The aim of the study was to compare long-term results of intracoronary implantation of drug-eluting stents (DES) and bare metal stents (BMS) in patients suffering from transplant coronary artery disease (TxCAD). Material and methods We performed a retrospective analysis of all intracoronary stent implantations for TxCAD among subjects with at least one follow-up coronary angiography. We identified 28 sirolimus-eluting DES ( n = 17) patients, 24 BMS ( n = 13 patients), and both DES and BMS ( n = 7 patients) implantations among 23 recipients. Mean follow-up after DES was 14 months and after BMS implantation, 20 months. We compared the occurrence of in-stent restenosis (ISR), and patient survival in the context of risk factors that were identified separately for each stent type. Significance was assessed using the log-rank, χ 2 and Mann-Whitney U test. Results There were 2 (7%) ISR among DES versus 14 (58%) ISR among BMS ( P = .0002) patients, with a longer time of freedom from IRS after DES implantation ( P = .022). There were three deaths (18%) among DES, four (31%) with BMS, and one (14%) with DES and BMS ( P = NS). Left anterior descending artery was the place of DES implantation in 17 (61%) versus 10 (42%) of BMS cases ( P = NS). Risk factor profile was comparable except for a higher age at the time of transplantation (46 ± 7 vs 41 ± 6 years; P = .011) and stent implantation (54 ± 7 vs 49 ± 6 years; P = .0002) for DES. Conclusion Favorable long-term results of sirolimus-eluting stents over BMS implanted for TxCAD suggested their preferential use in heart transplant recipients.