A1 Refereed original research article in a scientific journal

Bare-metal vs. drug-eluting stents in patients with atrial fibrillation undergoing percutaneous coronary intervention




AuthorsKiviniemi T, Puurunen M, Schlitt A, Rubboli A, Karjalainen P, Nammas W, Kirchhof P, Biancari F, Lip GY, Airaksinen KJ.

Publication year2014

JournalCirculation Journal

Journal acronymCirc J

Volume78

Issue11

First page 2674

Last page2681

Number of pages8

ISSN1346-9843

DOIhttps://doi.org/10.1253/circj.CJ-14-0792


Abstract

 

We explored 12-month clinical outcomes of 929 patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) with bare-metal stents (BMS) vs. drug-eluting stents (DES) from the prospective multicenter AFCAS (Atrial Fibrillation undergoing Coronary Artery Stenting) registry. METHODS AND RESULTS: Endpoints included the first occurrence of major adverse cardiac and cerebrovascular events (MACCE), defined as a composite of all-cause death, myocardial infarction (MI), target vessel revascularization, definite/probable stent thrombosis (ST), transient ischemic attack or stroke. Bleeding events were defined according to the Bleeding Academic Research Consortium criteria. Altogether, 673 (72.4%) patients received BMS and 220 (23.7%) at least one DES. Patients treated with DES more often had diabetes and prior ischemic events, and a longer stent length (P<0.05 for all), whereas patients treated with BMS more often had heart failure and were more likely to present with acute ST-elevation MI (P<0.05 for both). At 12-month follow-up, rates and risks of MACCE and total bleeding events were comparable between the groups (22.0% with BMS vs. 19.5% with DES, P=0.51, hazard ratio (HR) 0.89, 95% confidence interval (CI) 0.63-1.25 for DES) and (19.5% vs. 15.0%, respectively, P=0.16, HR 0.75, 95% CI 0.51-1.09 for DES). Definite/probable ST was more frequent in the BMS group (1.9% vs. 0%, respectively, P=0.046).



CONCLUSIONS:

In real-world patients with AF undergoing PCI, DES use was associated with outcomes comparable to those with BMS without excess bleeding complications. More ST was seen in BMS-treated patients.




Last updated on 2024-26-11 at 10:32