Drug-Eluting vs. Bare Stents in Older Patients Undergoing PCI
(HealthDay News) — For older patients undergoing percutaneous coronary intervention (PCI), drug-eluting stents (DES) offer clinical benefit over bare metal stents (BMS), according to a study published in the May 1 issue of The American Journal of Cardiology.
Fabio Mangiacapra, MD, PhD, from the Bio-Medico University of Rome, and colleagues examined the long-term efficacy and safety of DES in 635 consecutive elderly patients (≥75 years) who underwent PCI. One hundred seventy patients received at least one DES and 465 received BMS only. The researchers compared the incidence of net adverse clinical events (NACE) at a median follow-up of 31.2 months. Follow-up data were available for 593 patients.
The researchers found that at five years, the Kaplan-Meier estimate of NACE was significantly lower in the DES vs. the BMS group (40.5 vs. 55.7%). Benefit in the DES group was driven by significant reduction in myocardial infarction (8.6 vs. 16.6%) and target vessel revascularization rates (7.9 vs. 21.9%); there was no significant increase in the incidence of bleeding events (13.8 vs. 12.2%; P=0.882). Propensity score-adjusted Cox proportional hazard analysis confirmed these results.
"This net clinical benefit, resulting from persistent efficacy and safety over time, may support the use of DES as a reasonable option in patients ≥75 years," the authors write.