Long‐Term Follow‐Up of Coronary Venous Bypass Graft Lesions Treated with a New Generation Drug‐Eluting Stent with Bioabsorbable Polymer |
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| Authors: | RAINER WESSELY M.D. Ph.D. ANTONIO MARZOCCHI M.D. HARALD SCHWACKE M.D. OSMUND BERTEL M.D. PEEP LAANMETS M.D. ZORAN PERISIC M.D. RALPH TOELG M.D. NIKOLA JAGIC M.D. ALBRECHT ELSÄSSER M.D. GIAN BATTISTA DANZI M.D. |
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| Affiliation: | 1. Zentrum für Herz‐Gefaess‐ und Lungenmedizin Mediapark, , Cologne, Germany;2. Policlinico S. Orsola Malpighi, , Bologna, Italy;3. Krankenhaus der ev. Diakonieanstalt, , Speyer, Germany;4. Klinik im Park, , Zurich, Switzerland;5. North‐Estonia Regional Hospital, , Thallin, Estonia;6. Clinical Centre, , Nis, Serbia;7. Herz‐Kreislauf‐Zentrum, , Bad Segeberg, Germany;8. Clinical Centre, , Kragujevac, Serbia;9. Klinikum Oldenburg, , Oldenburg, Germany;10. Ospedale Maggiore Policlinico, , Milan, Italy |
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| Abstract: | Background To date, no published data are available regarding long‐term follow‐up of new generation DES implanted in coronary artery bypass graft (CABG) lesions. Objectives To assess the long‐term clinical outcome of patients receiving the new generation Biolimus A9‐coated drug‐eluting stent (DES) with biodegradable polymer in saphenous vein grafts (SVG). Methods Three thousand sixty‐seven patients were included in the NOBORI 2 registry: 71 patients with a total of 117 lesions received at least 1 biolimus A9 DES in SVG lesions and 2,959 patients received percutaneous coronary intervention in other lesions. Clinical follow‐up was performed at 1, 6, and 12 months, and annually up to 3 years. Results Compared to the non‐CABG group, patients with CABG lesions were older (P < 0.001), had a higher Charlson Comorbidity Index (P = 0.004), and presented more often with acute coronary syndrome (P = 0.02). At 3‐year follow‐up, cardiac death occurred in 9.7% versus 2.1% (P < 0.001), myocardial infarction (MI) in 8.3% versus 3.0% (P = 0.02), target lesion failure in 13.9% versus 6.4% (P = 0.03), and major adverse cardiac event in 18.1% versus 8.6% (P = 0.01). No differences were observed in TV‐MI and TLR, nor stent thrombosis (ST) which was generally low in both groups (1.4% vs 0.8%, P = NS). Conclusion Albeit 3‐year outcomes were less favorable in the CABG group, the higher cardiac mortality was apparently not driven by ST, target vessel MI, or TLR, but is likely due to advanced disease and age as well as comorbidity. The low TLR rate as well as the absence of late and very late ST suggest that BES are safe and effective for the treatment of CABG lesions. (J Interven Cardiol 2013;26:425‐433) |
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