• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

Drug-eluting stents for saphenous vein grafts associated with better outcomes than bare-metal stents

byBrian DoughertyandAlex Chan
October 23, 2020
in Cardiology, Chronic Disease, Surgery
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. Among patients who have received a saphenous vein graft during coronary bypass surgery and later experience treatment failure, deployment of a drug-eluting stent during percutaneous coronary intervention leads to more favorable outcomes than does use of a bare-metal stent.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Though it has been shown in previous studies that drug-eluting stents (DES) are associated with more favorable outcomes than bare-metal stents (BMS) when stenting native vessels, data regarding the stenting of saphenous vein grafts (SVGs) is less clear. SVGs are commonly implanted during coronary bypass surgery; due to the relatively high rate of post-operative occlusion, 6% of all percutaneous coronary interventions are performed on SVGs. There is a paucity of data for this particular intervention, some of which is conflicting. A recent trial found no difference in outcome at 12 months between DES and BMS when stenting SVG lesions. To clarify these findings, this study assessed the efficacy and safety of DES among patients undergoing percutaneous coronary intervention in SVG lesions over a longer, five-year period.

In this randomized controlled trial, patients were recruited from six clinical centers in Switzerland, Germany, and Denmark, and randomized 1:1 during coronary intervention to received either a paclitaxel-eluting stent (DES cohort) or a bare-metal stent (BMS cohort). The primary outcome was the incidence of major adverse cardiac events (MACE), defined as the composite of cardiac death, nonfatal myocardial infarction, and target vessel revascularization (TVR) of the stented SVG. At one year, the BMS cohort has a significantly higher incidence of MACE as well as TVR. Furthermore, at the five-year follow-up, incidence of MACE remained significantly in favor of DES. The randomized design of this study lends credence to its findings, though it should be noted that study enrollment was prematurely terminated and thus the study was unpowered, which may have impacted the results. In all, this study suggests that among patients presenting for percutaneous coronary intervention of SVG lesions, the use of DES leads to more favorable outcomes when compared with BMS, and therefore may be the preferred intervention in this population.

Click here to read the study in JAHA

Relevant reading: Drug-eluting stents versus bare-metal stents in saphenous vein grafts: a double-blind, randomised trial

In-depth [randomized controlled trial]: 173 patients with SVG were included in this study, with 89 (mean [SD] age = 70.5 [7.9] years, 89.9% male) randomized to receive DES and 84 (mean [SD] age = 71.4 [8.7] years, 89.3% male) randomized to receive BMS. At one year, the incidence of MACE was significantly higher in the BMS cohort (HR 0.14, 95% CI 0.03 to 0.64, p = 0.01), as was the need for TVR (10.1% vs. 0% in the DES cohort, HR 0.05, 95% CI 0.00 to 0.44, p = 0.003). After adjusting for potential confounders like age, sex, and diabetes mellitus, the advantage of DES in terms of MACE remained significant (HR 0.16, 95% CI 0.03 to 0.71, p = 0.01). At five years, the incidence of MACE continued to favor DES compared with BMS (35.5% vs. 56.1%, HR 0.40, 95% CI 0.23 to 0.68, p < 0.001). When considering the need for TVR, an advantage for patients treated with DES compared with BMS was again demonstrated (13.9% vs. 37.5%, HR 0.23, 95% CI 0.10 to 0.51, p < 0.001). Finally, the need for TVR among patients treated with DES was consistently lower throughout the five-year follow-up period when compared with patients treated with BMS (1-5 years HR 0.33, 95% CI 0.13 to 0.74, p = 0.007). Of note, patients treated with BMS presented more frequently for multiple TVR procedures compared with patients treated with DES (n = 8 [9.5%] vs. n = 1 [1.1%], p = 0.013).

RELATED REPORTS

Mediterranean diet superior to low-fat diet in secondary prevention of cardiovascular events

2 Minute Medicine Rewind May 22nd, 2022

Associations remain inconclusive between religiosity and spirituality on medication adherence in cardiovascular disease

Image: PD

©2020 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: cardiologyCoronary artery diseaseembolismPCIstentvascular surgery
Previous Post

Outcomes of COVID-19-related ARDS patients on extracorporeal membrane oxygenation

Next Post

Caesarian section delivery due to dystocia associated with decreased vitamin D level

RelatedReports

FDA-approved weight loss medications associated with weight loss at one year
Cardiology

Mediterranean diet superior to low-fat diet in secondary prevention of cardiovascular events

May 25, 2022
Weekly Rewinds

2 Minute Medicine Rewind May 22nd, 2022

May 23, 2022
Cardiology

Associations remain inconclusive between religiosity and spirituality on medication adherence in cardiovascular disease

May 16, 2022
Image-guided percutaneous drainage of pericardial effusions is safe and effective
Weekly Rewinds

2 Minute Medicine Rewind, May 16

May 16, 2022
Next Post
Increased complications associated with emergent repeat cesarean

Caesarian section delivery due to dystocia associated with decreased vitamin D level

Intensive rehabilitation not superior to traditional therapy for arm function after stroke

2 Minute Medicine Rewind October 26, 2020

Novel coronavirus identified from patients with pneumonia in Wuhan, China

Significant mortality rate variation associated with race in the United States

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

Get 2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Alzheimer disease in individuals with Down syndrome has similar variability in age of onset and mortality rate as autosomal dominant forms
  • #VisualAbstract: Ruxolitinib shows long-term safety and efficacy in inadequately controlled polycythaemia vera without splenomegaly
  • Wellness Check: Sleep
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.