More CV Events with PCI Drug-Eluting Stents

At a median follow-up of 4.6 years, the rates of repeat revascularization and spontaneous myocardial infarction were significantly higher after PCI than after CABG.
At a median follow-up of 4.6 years, the rates of repeat revascularization and spontaneous myocardial infarction were significantly higher after PCI than after CABG.

(HealthDay News) -- For patients with multivessel coronary artery disease, percutaneous coronary intervention (PCI) with everolimus-eluting stents is linked to increased cardiovascular events versus coronary artery bypass grafting (CABG), while the risk of death is similar for PCI with everolimus-eluting stents and CABG. These findings were published online March 16 in the New England Journal of Medicine to coincide with the annual meeting of the American College of Cardiology, held from March 14 to 16 in San Diego.

Seung-Jung Park, M.D., from the University of Ulsan College of Medicine in South Korea, and colleagues conducted a noninferiority trial involving 880 patients with multivessel coronary artery disease (438 randomized to PCI with everolimus-eluting stents; 442 randomized to CABG). The researchers found that the primary end point (composite of death, myocardial infarction, or target-vessel revascularization) occurred in 11.0 and 7.9% of patients, respectively, at 2 years (absolute risk difference, 3.1%; P = 0.32 for noninferiority). At a median follow-up of 4.6 years, the rates of repeat revascularization and spontaneous myocardial infarction were significantly higher after PCI than after CABG.

Sripal Bangalore, M.D., M.H.A., from the New York University School of Medicine in New York City, and colleagues compared the outcomes of patients with multivessel disease who underwent CABG (9,223 patients) versus those who underwent PCI with everolimus-eluting stents (9,223 patients). The researchers found that the risk of death was similar for PCI and CABG at a mean follow-up of 2.9 years (3.1 and 2.9%, respectively).

"We need better ways to aggregate and analyze large amounts of clinical data to better inform practice at the point of care," write the authors of an accompanying editorial.

Both studies received financial support from Abbott Vascular.

Sources

  1. Park, SJ, et al. New England Journal of Medicine, March 16, 2015; doi: 10.1056/NEJMoa1415447.
  2. Bangalore, S, et al. New England Journal of Medicine, March 16, 2015; doi: 10.1056/NEJMoa1412168.
  3. Robert A. Harrington, M.D. New England Journal of Medicine, March 16, 2015; doi: 10.1056/NEJMe1501045.
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