Abstract 5593: Long-term Follow-up of Patients with Unstable Angina Treated with Drug-Eluting Stents: Pooled Analysis from 14 Clinical Trials
Objectives To assess long-term safety and efficacy of drug-eluting stents (DES) in patients (pts) undergoing percutaneous coronary intervention (PCI) in the setting of unstable angina (UA).
Background Plaque rupture and thrombus formation are the hall markers of acute coronary syndromes. The data on safety and efficacy of DES in increased thrombotic environment are scant.
Methods We examined the outcomes of pts with UA in the pooled analysis from 14 clinical trials comparing DES with a bare-metal stent (BMS). Outcomes were stratified by clinical syndrome acuity on admission.
Results Among a total of 8,324 pts, 2,959 pts (35.5%) had UA. Clinical outcomes at 30-days were similar in patients treated with DES vs. BMS. On angiographic follow-up, patients assigned to DES had significantly less late loss resulting in a marked 75% reduction of analysis segment restenosis. At 2-year F/U (Figure⇓), patients assigned to DES compared to BMS had similar rates of cardiac death and stent thrombosis (ST) analyzed either by protocol definition or by the Academic Research Consortium definition (definite/probable ST), and lower rates of myocardial infarction (MI), target lesion revascularization (TLR) and target vessel revascularization (TVR).
Conclusions In this analysis, treatment of patients with UA with DES compared with BMS was safe and effective, resulting in notably improved clinical outcomes at 2 years, with similar rates of ST.