Sobrevida aos dez anos de pacientes submetidos a angioplastia coronária com stents sirolimus de primeira geração e stents metálicos

Translated title of the contribution: Ten-year survival of patients undergoing coronary angioplasty with first-generation sirolimus-eluting stents and bare-metal stents

Nelson Vale, Sérgio Madeira, Manuel Almeida, Luís Raposo, Pedro Freitas, Mariana Castro, Gustavo Rodrigues, Afonso Oliveira, João Brito, Sílvio Leal, Pedro de Araújo Gonçalves, Henrique Mesquita Gabriel, Rui Campante Teles, Ricardo Seabra Gomes

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: Compared to bare-metal stents (BMS), drug-eluting stents reduce stent restenosis and improve subsequent revascularization rates. The impact on patients’ survival has been the subject of debate. Objective: To assess the long-term (10-year) survival of patients undergoing percutaneous coronary intervention (PCI) with first-generation sirolimus-eluting stents (SES) in comparison with BMS. Methods: In a single-center registry, 600 consecutive patients who underwent successful PCI with SES between April 2002 and February 2003 were compared to 594 patients who underwent PCI with BMS between January 2002 and April 2002, just before the introduction of SES. Clinical and procedural data were collected at the time of intervention and 10-year survival status was assessed via the national life status database. Results: All baseline characteristics were similar between groups except for smaller stent diameter (2.84±0.38 vs. 3.19±0.49 mm; p<0.001), greater stent length (18.50±8.2 vs. 15.96±6.10 mm; p<0.001) and higher number of stents per patient (1.95 vs. 1.46, p<0.001) in the SES group. Overall five- and 10-year all-cause mortality was 9.6% (n=110) and 22.7% (n=272), respectively. The adjusted HR for 10-year mortality in patients undergoing PCI with SES was 0.74 (95% CI 0.58-0.94; p=0.013), corresponding to a relative risk reduction of 19.8%. Other than PCI with BMS, older age, chronic kidney disease, chronic obstructive pulmonary disease and lower ejection fraction were independent predictors of 10-year mortality. Conclusion: To date, this is the longest follow-up study ever showing a potential survival benefit of first-generation sirolimus-eluting stents versus bare-metal stents, supporting prior observations on their sustained efficacy and safety relative to contemporary BMS.

Translated title of the contributionTen-year survival of patients undergoing coronary angioplasty with first-generation sirolimus-eluting stents and bare-metal stents
Original languagePortuguese
Pages (from-to)639-647
JournalRevista Portuguesa de Cardiologia
Volume39
Issue number11
DOIs
Publication statusPublished - Nov 2020

Keywords

  • Bare-metal stent
  • Coronary disease
  • Coronary intervention
  • Sirolimus-eluting stent

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