NEW YORK (Reuters Health) – Using paclitaxel-eluting stents to treat saphenous vein graft (SVG) lesions is associated with better outcomes than is the use of bare metal stents, researchers report in JACC: Cardiovascular Interventions for February.

The authors explain that the benefits of drug-eluting stents over bare metal stents (BMS) are not clear. An early angiographic and clinical advantage was seen at 18 months with paclitaxel-eluting stents (PES) in the Stenting of Saphenous Vein Grafts (SOS) trial. The current report describes longer-term outcomes.

SOS included 80 men randomized to BMS or PES for treatment of stenotic saphenous vein grafts a mean of 12 years after graft placement. During a median follow-up of 35 months, 52 of the patients experienced at least one major adverse cardiac event. These events were related to the target SVG in 77% of BMS patients and in 45% of PES patients.

“Compared with patients randomized to BMS, those receiving PES had a lower incidence of myocardial infarction (hazard ratio [HR]: 0.32, p= 0.01), target lesion revascularization (HR: 0.20, p=0.004), target vessel revascularization (HR: 0.41, p=0.03), and target vessel failure (HR: 0.34, p= 0.001),” report Dr. Emmanouil S. Brilakis, at the Dallas VA Medical Center in Texas, and colleagues.

There was also a trend toward less stent thrombosis (HR: 0.15, p=0.08) with PES, but mortality rates were not statistically different between the two groups.

“This extended analysis of the SOS trial suggests that placement of a PES in SVG lesions continued to provide benefit during a median follow-up period of 35 months compared with BMS,” the investigators conclude.

Reference:

New Method of Intracoronary Adenosine Injection to Prevent Microvascular Reperfusion Injury in Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

J Am Coll Cardiol Intv 2011;4:176–182.