This article is more than 5 years old. Information may no longer be current.
SCAAR: New-generation DES safer than older DES, BMS
Sarno G. Eur Heart J. 2012;doi:10.1093/eurheartj/ehr479.
Click Here to Manage Email Alerts
New findings from the Swedish Coronary Angiography and Angioplasty Registry show that percutaneous coronary intervention using new-generation drug-eluting stents is associated with lower rates of restenosis, stent thrombosis and subsequent mortality than older drug-eluting stents and bare metal stents.
A search of the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) yielded 61,351 patients who received 94,384 stent implantations performed in Sweden from November 2006 to October 2010. Data were compiled on implantations using bare metal stents (BMS); older-generation drug-eluting stents (DES), including Cypher and Cypher Select (Cordis), Taxus Express and Taxus Liberté (Boston Scientific) and Endeavor (Medtronic); and new-generation DES, including Endeavor Resolute (Medtronic), Xience V and Xience Prime (Abbott Laboratories) and Promus and Promus Element (Boston Scientific).
“PCI with newer-generation DES is associated with a 38% lower risk of clinically meaningful restenosis, a 43% lower risk of definite [stent thrombosis] and a 23% lower risk of death compared with older-generation DES in this observational study from a large real-world population,” researchers wrote in the study.
According to the results, rates of restenosis increased from 2.8% at 1 year to 3.9% at 2 years with new-generation DES; from 4% to 5.8% with older DES; and from 6.3% to 7.4% with BMS. Similar results were found for rates of definite stent thrombosis between 1 and 2 years: 0.5% to 0.6% with new-generation DES; 0.9% to 1.3% with older DES; and 1.2% to 1.4% with BMS. Cox regression analysis revealed lower risks for restenosis with new-generation DES compared with older DES (HR=0.62; 95% CI, 0.53-0.72) and BMS (HR=0.29; 95% CI, 0.25-0.33). Lower risks for definite stent thrombosis also were reported when comparing new-generation DES with older-generation DES (HR=0.57; 95% CI, 0.41-0.79) and BMS (HR=0.38; 95% CI, 0.28-0.52).
The risk for death with newer DES was lower when compared with both older-generation DES (HR=0.77; 95% CI, 0.63-0.95) and BMS (HR=0.55; 95% CI, 0.46-0.67). Compared with BMS, older DES were associated with lower mortality (HR=0.72; 95% CI, 0.64-0.81). Overall, 5.6% of patients included in the registry died at 2 years.
“The low rates of restenosis and stent thrombosis correspond with the results of several recent randomized trials and this may well translate into mortality reduction in a sufficiently large study population,” SCAAR investigator Stefan James, MD, PhD, of Uppsala University Hospital in Sweden, said in a press release.
The researchers said the SCAAR analysis included only patients who were treated after 2006.
“Since 2006, no major changes in recommendations for antithrombotic strategies for duration of dual antiplatelet therapy have occurred in Sweden, so it seems likely that our more favorable outcomes are true findings,” James said.
Disclosure: Dr. James has received institutional research grants from Medtronic, Terumo and Vascular Solutions.
 |
Follow CardiologyToday.com on Twitter. |