Abstract
Objective: To compare one year clinical outcomes of patients with chronic stable angina who underwent implantation of bare metal stent (BMS) or drug eluting stent (DES).Methodology: Four hundred forty two (442) participants of OPCES study (Osvix versus Plavix in Cardiovascular Events after Stenting) were included in this sub-study. After evaluation of exclusion criteria (combined DES and BMS stenting (n=31) and incomplete data (n=48) patients were divided in two groups according to selected stent(DES or BMS). Follow-up was conducted by a structured telephone interview after 6 and 12 months. The patients’ documents were reviewed by the Study Event Committee in the Isfahan Cardiovascular Research Center to evaluate the occurrence of study endpoints which consisted of clinical success rate and major adverse cardiac events (Major Adverse Cardiac Events (MACE), cardiac death, non-fatal MI, target vessel revascularization and stroke) in hospital, after 6 and 12 months.Results: One hundred sixty six (45.7%) patients were in the DES and 197(54.3%) were in the BMS group. Procedural complications were seen more frequently in the DES group (1.0% vs. 4.8%, P=0.027), the prevalence of the in-hospital MACE, angiographic and clinical success rate were the same between both the groups. There was no significant difference regarding 6 and 12 months MACE rate in patients treated by BMS or DES (6 months: 1.1% vs. 0.6%, p>0.999 12 month: 3.4% vs 2.6%, P = 0.755).Conclusion: Considering the same clinical outcome and the economical parameters, use of the BMS after proper patient selection are recommended.doi: http://dx.doi.org/10.12669/pjms.291(Suppl).3512How to cite this:Khosravi AR, Raoufi A, Pourmoghadas M, Paydari N, Gharipour M, Namdari M, et al. Late clinical events of drug eluting versus bare metal stenting; OPCES’ ancillary study. Pak J Med Sci 2013;29(1)Suppl:258-263. doi: http://dx.doi.org/10.12669/pjms.291(Suppl).3512This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Highlights
Coronary stenting is an established form of the treatment for the majority of patients with symptomatic coronary artery disease (CAD)
Randomized controlled trials have shown that drug-eluting stents (DES) have resulted in a substantial decrease in restenosis across a wide range of coronary lesions and patient subsets compared to bare metal stents (BMS).[3,4]
In Iran, long-term clinical outcome of stenting by DES versus BMS were compared in a few studies but all of them were based on single center registries or trials
Summary
Coronary stenting is an established form of the treatment for the majority of patients with symptomatic coronary artery disease (CAD). DES vs BMS questions about the safety and efficacy of these stents.[7,8,9,10] Recent studies suggest a 0.5% increased long-term thrombosis risk with DES; the clinical significance of these events remains under debate[11] and in a real-world setting, use of DES in all patients is less cost effective than in studies with selected patients.[12]. In Iran, long-term clinical outcome of stenting by DES versus BMS were compared in a few studies but all of them were based on single center registries or trials. In present study we aimed at comparing the 1-year clinical outcomes of the patients who underwent BMS or DES placement in the Iranian patients’ subsets participating in the multicentric study
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