Long-Term Clinical Outcomes After Drug-Eluting and Bare-Metal Stenting in Massachusetts
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- Laura Mauri
- From Brigham and Women’s Hospital (L.M., Z.Z., F.S.R.) and Harvard Clinical Research Institute (L.M.); Harvard Medical School (L.M., T.S.S., R.E.W., K.Z., A.L., F.S.R., S.-L.T.N.); and Harvard School of Public Health (S.-L.T.N.), Boston, Mass.
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- Treacy S. Silbaugh
- From Brigham and Women’s Hospital (L.M., Z.Z., F.S.R.) and Harvard Clinical Research Institute (L.M.); Harvard Medical School (L.M., T.S.S., R.E.W., K.Z., A.L., F.S.R., S.-L.T.N.); and Harvard School of Public Health (S.-L.T.N.), Boston, Mass.
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- Robert E. Wolf
- From Brigham and Women’s Hospital (L.M., Z.Z., F.S.R.) and Harvard Clinical Research Institute (L.M.); Harvard Medical School (L.M., T.S.S., R.E.W., K.Z., A.L., F.S.R., S.-L.T.N.); and Harvard School of Public Health (S.-L.T.N.), Boston, Mass.
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- Katya Zelevinsky
- From Brigham and Women’s Hospital (L.M., Z.Z., F.S.R.) and Harvard Clinical Research Institute (L.M.); Harvard Medical School (L.M., T.S.S., R.E.W., K.Z., A.L., F.S.R., S.-L.T.N.); and Harvard School of Public Health (S.-L.T.N.), Boston, Mass.
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- Ann Lovett
- From Brigham and Women’s Hospital (L.M., Z.Z., F.S.R.) and Harvard Clinical Research Institute (L.M.); Harvard Medical School (L.M., T.S.S., R.E.W., K.Z., A.L., F.S.R., S.-L.T.N.); and Harvard School of Public Health (S.-L.T.N.), Boston, Mass.
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- Zheng Zhou
- From Brigham and Women’s Hospital (L.M., Z.Z., F.S.R.) and Harvard Clinical Research Institute (L.M.); Harvard Medical School (L.M., T.S.S., R.E.W., K.Z., A.L., F.S.R., S.-L.T.N.); and Harvard School of Public Health (S.-L.T.N.), Boston, Mass.
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- Frederic S. Resnic
- From Brigham and Women’s Hospital (L.M., Z.Z., F.S.R.) and Harvard Clinical Research Institute (L.M.); Harvard Medical School (L.M., T.S.S., R.E.W., K.Z., A.L., F.S.R., S.-L.T.N.); and Harvard School of Public Health (S.-L.T.N.), Boston, Mass.
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- Sharon-Lise T. Normand
- From Brigham and Women’s Hospital (L.M., Z.Z., F.S.R.) and Harvard Clinical Research Institute (L.M.); Harvard Medical School (L.M., T.S.S., R.E.W., K.Z., A.L., F.S.R., S.-L.T.N.); and Harvard School of Public Health (S.-L.T.N.), Boston, Mass.
抄録
<jats:p> <jats:bold> <jats:italic>Background—</jats:italic> </jats:bold> Drug-eluting stents (DES) reduce the need for repeat revascularization, but their long-term safety relative to that of bare-metal stents (BMS) in general use remains uncertain. We sought to compare the clinical outcome of patients treated with DES with that of BMS. </jats:p> <jats:p> <jats:bold> <jats:italic>Methods and Results—</jats:italic> </jats:bold> All adults undergoing percutaneous coronary intervention with stenting between April 1, 2003, and September 30, 2004, at non–US government hospitals in Massachusetts were identified from a mandatory state database. Patients were classified from the index admission according to stent types used. Clinical and procedural risk factors were collected prospectively. Risk-adjusted mortality, myocardial infarction, and revascularization rate differences (DES−BMS) were estimated through propensity score matching without replacement. A total of 11 556 patients were treated with DES, and 6237 were treated with BMS, with unadjusted 2-year mortality rates of 7.0% and 12.6%, respectively ( <jats:italic>P</jats:italic> <0.0001). In 5549 DES patients matched to 5549 BMS patients, 2-year risk-adjusted mortality rates were 9.8% and 12.0%, respectively ( <jats:italic>P</jats:italic> =0.0002), whereas the respective rates for myocardial infarction and target-vessel revascularization were 8.3% versus 10.3% ( <jats:italic>P</jats:italic> =0.0005) and 11.0% versus 16.8% ( <jats:italic>P</jats:italic> <0.0001). </jats:p> <jats:p> <jats:bold> <jats:italic>Conclusions—</jats:italic> </jats:bold> DES treatment was associated with lower rates of mortality, myocardial infarction, and target-vessel revascularization than BMS treatment in similar patients in a matched population-based study. Comprehensive follow-up in this inclusive population is warranted to identify whether similar safety and efficacy remain beyond 2 years. </jats:p>
収録刊行物
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- Circulation
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Circulation 118 (18), 1817-1827, 2008-10-28
Ovid Technologies (Wolters Kluwer Health)