Faculty Collaboration Database

Drug eluting versus bare metal stents in cardiac allograft vasculopathy: a systematic review of literature. Catheter Cardiovasc Interv 2011 Jun 01;77(7):962-9

Date

03/18/2011

Pubmed ID

21413135

DOI

10.1002/ccd.22975

Scopus ID

2-s2.0-79958269707 (requires institutional sign-in at Scopus site)   38 Citations

Abstract

BACKGROUND: Cardiac allograft vasculopathy (CAV) is a distinct pathological condition characterized by diffuse and progressive arteriopathy and it is an important determinant of long-term graft survival. Definitive CAV treatment is retransplantation but palliation with stenting might temporarily alleviate it. The benefit of drug eluting stents (DES) over bare metal stents (BMS) in the treatment of such lesions is debatable. We therefore sought to do a literature search to review the available evidence comparing DES to BMS.

METHODS: We conducted Pub Med, EMBASE, Cochrane database review, Web of Science search of studies comparing DES with BMS in CAV. Available studies were retrospective in nature with either direct comparison groups (n = 5) or historical controls (n = 1). The main outcomes analyzed were in stent restenosis (ISR) during follow-up and clinical outcomes.

RESULTS: A total of 312 patients from six studies were included in the review (1995-2007). Most commonly used DES were sirolimus eluting stent. DES appeared to reduce the long-term risk of ISR compared with BMS. Three of the five studies showed a statistically significant reduction in ISR at 12 months while the one study assessing ISR at 6 months showed no significant difference. Clinical endpoints such as death and major adverse cardiac events were not statistically different.

CONCLUSION: DES appear to reduce the incidence of ISR in CAV as compared with BMS. Prospective randomized clinical trials are needed to determine the clinical benefit of DES beyond a reduction in ISR.

Author List

Dasari TW, Hennebry TA, Hanna EB, Saucedo JF

Author

Jorge Saucedo MD Chief, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Angioplasty, Balloon, Coronary
Coronary Artery Disease
Coronary Restenosis
Drug-Eluting Stents
Evidence-Based Medicine
Female
Graft Survival
Heart Transplantation
Humans
Male
Metals
Middle Aged
Palliative Care
Prosthesis Design
Risk Assessment
Risk Factors
Stents
Time Factors
Transplantation, Homologous
Treatment Outcome