AI Article Synopsis
- The study aimed to compare the safety and efficacy of drug-eluting stents (DES) versus bare metal stents (BMS) in patients with Spontaneous Coronary Artery Dissection (SCAD), as DES may affect healing.
- 238 patients with SCAD were identified, with 108 receiving stenting; results showed no significant differences in procedure complications, but there was a trend towards better outcomes for those receiving DES, particularly in terms of target vessel revascularization and overall prognosis.
- Overall, DES appeared to be as safe as BMS, with a potential long-term efficacy advantage, although further research is needed for definitive conclusions.
Article Abstract
Aims: Given the different pathogenesis, use of drug eluting stent (DES) in patients with Spontaneous Coronary Artery Dissection SCAD may delay the healing of the dissected vessel. Aim of our study was to compare the safety and the efficacy of DES vs. bare metal stent (BMS) in a cohort of patients who underwent stenting for SCAD.
Methods And Results: Consecutive patients with SCAD between January 1995 and August 2014 were retrospectively identified in 12 centers and included. Major Adverse Cardiac Events (MACE) was the primary end point. A total of 238 SCAD patients were identified: of them 108 patients underwent PCI with DES or BMS. Overall 24 patients (22.2%) suffered an intra-procedural complication without any differences between the 2 groups. At median follow-up of 1201days (Inter Quartile Range 541-2760), incidence of the primary endpoint showed a trend towards less events in the DES-treated patients (38.7% vs. 25.9% p=0.14) mainly driven by the benefit of DES in terms of TVR (17.6% vs. 4%, p=0.08), mortality (16.8% vs. 9.3%, p=0.4), and MI rate (16% vs. 8.4%, p=0.33). STEMI at presentation (HR 6.4, CI 95% 1.29-31.9, p=0.02) but not kind of stent (HR 0.97, CI 95% 0.2-4.7, p=0.9) emerged as independently related to prognosis at multivariable analysis.
Conclusions: In SCAD patients use of DES seems to be as safe as BMS with trend of better efficacy in the long term.
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| http://dx.doi.org/10.1016/j.ijcard.2017.03.027 | DOI Listing |
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