Abstract 17341: Use and Effectiveness of Drug-Eluting versus Bare Metal Stents in Saphenous Vein Bypass Graft Percutaneous Coronary Interventions: Insights from the National VA Clinical Assessment, Reporting and Tracking (CART) Program
Background: Little is known about the use and outcomes of drug eluting stents (DES) versus bare metal stents (BMS) in saphenous vein graft (SVG) percutaneous coronary interventions (PCI).
Methods: From the National VA CART program database of 59 catheterization laboratories, we identified all VA patients undergoing SVG PCI (n=2636). Based on a propensity score to receive a DES, we identified a matched cohort of 920 patients who received a DES to 920 patients who received a BMS (n=1840 total) during an index SVG PCI between October, 2004 and September, 2010. Kaplan-Meier analyses were performed to determine the association of DES vs BMS use and follow-up myocardial infarction, revascularization and death.
Results: SVG PCI represented 7.3% of the total PCI volume (2636 of 36,256 patients). Of these, 1615 (61.2%) were treated with a DES and embolic protection devices were successfully used in 32.5% of patients. In the propensity matched cohort, the 2-year rate of MI was significantly lower among patients who received DES versus BMS (19% vs 23.9%, p=0.005) (Figures). However, the 2 year mortality and revascularization rates were not significantly different in the DES versus BMS groups respectively (9.2% vs 12.0%, p= 0.14 and 22.3% vs 20.6%, p=0.24).
Conclusion: In a large national SVG-PCI registry, DES compared to BMS use was associated with lower rates of MI but similar revascularization and death rates.
- © 2011 by American Heart Association, Inc.