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Title: Sustained risk of stent thrombosis and restenosis in first generation drug-eluting Stents after One Decade of Follow-up: A Report from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR).
Author: Völz S, Angerås O, Odenstedt J, Ioanes D, Haraldsson I, Dworeck C, Redfors B, Råmunddal T, Albertsson P, Petursson P, Omerovic E.
Journal: Catheter Cardiovasc Interv; 2018 Nov 15; 92(6):E403-E409. PubMed ID: 29745465.
Abstract:
AIMS: Long-term comparisons between Drug-eluting stent and bare metal stent are not well-studied. The aim of this study was to compare two stents that were previously frequently used in regard to long-term risk of restenosis and stent thrombosis (ST). METHODS AND RESULTS: We used data from the SCAAR registry. Consecutive procedures performed between 2004 and 2014 for stable angina, UA/NSTEMI and STEMI were included. We compared two different stents: Cordis Cypher Select (C-CS), and Boston Scientific Liberte (BS-L), modeling data with multilevel Cox proportional-hazards regression. The primary endpoint was time to first occurrence of either ST or restenosis. During the study period 2210 C-CS and 6941 B-SL were implanted in 5,314 patients. Mean follow-up time was 2,288 days for C-CS and 2,297 days for BS-L. Treatment with C-CS was associated with lower risk for restenosis or ST up to one year from index procedure (HR 0.41; 95% CI 0.32-0.52; P < .001). However, after one year of follow-up, risk was substantially higher in C-CS (HR 2.81; 95% CI 2.25-3.50; P < .001). CONCLUSION: Treatment with C-CS was not associated with better outcome than BS-L. Continuation of restenosis and ST long after the index procedure with C-CS present a major concern for patient safety.

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