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Comparison of Frequency of Major Adverse Events in Patients With Atrial Fibrillation Receiving Bare-Metal Versus Drug-Eluting Stents in Their Coronary Arteries
- Source :
- The American Journal of Cardiology. 110:7-12
- Publication Year :
- 2012
- Publisher :
- Elsevier BV, 2012.
-
Abstract
- In patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention with drug-eluting stent (DES) implantation, the available evidence from clinical trial data are inconclusive. We evaluated the safety and efficacy of the use of DESs versus bare-metal stents (BMSs) in a consecutive real-world cohort of patients with AF. Of 8,962 unselected patients with AF seen in our institution from 2000 through 2010, 833 (9%) had undergone percutaneous coronary intervention with stent implantation. BMSs were used for 678 patients (81%) and DESs for 155 (19%). During follow-up (median 688 days, interquartile range 1,114), all bleeding episodes, thromboembolism, and major adverse cardiac events (MACEs; i.e., death, acute myocardial infarction, target lesion revascularization) were recorded. Incidence of MACEs was similar in the 2 groups as was incidence of all-cause mortality. Results remained similar even after adjustment for age and other confounding factors. Factors independently associated with an increased risk of MACEs were older age (hazard ratio 1.024, 95% confidence interval 1.004 to 1.044, p = 0.02), implantation of stent during acute ST-segment elevation myocardial infarction (hazard ratio 1.81, 95% confidence interval 1.10 to 2.99, p = 0.02), and stent diameter (hazard ratio 1.09, 95% confidence interval 1.01 to 1.18, p = 0.03). Implantation of DESs was not significantly associated with a higher risk of major bleeding and we observed a similar ratio of serious events at follow-up after DES compared to BMS implantation. In conclusion, in our cohort, systematic use of DESs does not seem to be justified in most patients with AF because it was not associated with any clear advantage compared to BMSs.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Coronary Artery Disease
Coronary Angiography
Postoperative Complications
Risk Factors
Interquartile range
Internal medicine
Atrial Fibrillation
medicine
Humans
cardiovascular diseases
Myocardial infarction
Aged
Retrospective Studies
business.industry
Incidence
Hazard ratio
Stent
Percutaneous coronary intervention
Drug-Eluting Stents
Atrial fibrillation
Prognosis
medicine.disease
Confidence interval
Surgery
Coronary arteries
medicine.anatomical_structure
Cardiology
Female
France
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 00029149
- Volume :
- 110
- Database :
- OpenAIRE
- Journal :
- The American Journal of Cardiology
- Accession number :
- edsair.doi.dedup.....047bdf91f7873c3f64693428c4f68034