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Effectiveness and Safety of Drug-Eluting Stents in Ontario.
- Source :
-
New England Journal of Medicine . 10/4/2007, Vol. 357 Issue 14, p1393-1402. 10p. 1 Diagram. - Publication Year :
- 2007
-
Abstract
- Background: The placement of drug-eluting stents decreases the frequency of repeat revascularization procedures in patients undergoing percutaneous coronary intervention (PCI) in randomized clinical trials. However, there is uncertainty about the effectiveness of drug-eluting stents, and increasing concern about their safety, in routine clinical practice. Methods: From the Cardiac Care Network of Ontario's population-based clinical registry of all patients undergoing PCI in Ontario, Canada, we identified a well-balanced cohort of 3751 pairs of patients, matched on the basis of propensity score, who received either bare-metal stents alone or drug-eluting stents alone during an index PCI procedure between December 1, 2003, and March 31, 2005. The primary outcomes of the study were the rates of target-vessel revascularization, myocardial infarction, and death. Results: The 2-year rate of target-vessel revascularization was significantly lower among patients who received drug-eluting stents than among those who received bare-metal stents (7.4% vs. 10.7%, P<0.001). Drug-eluting stents were associated with significant reductions in the rate of target-vessel revascularization among patients with two or three risk factors for restenosis (i.e., presence of diabetes, small vessels [<3 mm in diameter], and long lesions [≥20 mm]) but not among lower-risk patients. The 3-year mortality rate was significantly higher in the bare-metal–stent group than in the drug-eluting–stent group (7.8% vs. 5.5%, P<0.001), whereas the 2-year rate of myocardial infarction was similar in the two groups (5.2% and 5.7%, respectively; P=0.95). Conclusions: Drug-eluting stents are effective in reducing the need for target-vessel revascularization in patients at highest risk for restenosis, without a significantly increased rate of death or myocardial infarction. N Engl J Med 2007;357:1393-402. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00284793
- Volume :
- 357
- Issue :
- 14
- Database :
- Academic Search Index
- Journal :
- New England Journal of Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 26961566
- Full Text :
- https://doi.org/10.1056/NEJMoa071076