Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jan;33(1):10-19.
doi: 10.6515/acs20160608a.

Comparison of Clinical Outcomes in Patients Undergoing Coronary Intervention with Drug-Eluting Stents or Bare-Metal Stents: A Nationwide Population Study

Shih-Hsien Sung  1 , Tzu-Ching Chen  2 , Hao-Min Cheng  3 , Jia-Chun Lee  4 , Hui-Chu Lang  5 , Chen-Huan Chen  6
Affiliations

Comparison of Clinical Outcomes in Patients Undergoing Coronary Intervention with Drug-Eluting Stents or Bare-Metal Stents: A Nationwide Population Study

Shih-Hsien Sung et al. Acta Cardiol Sin. 2017 Jan.

Abstract

Background: The aim of this propensity score-matched cohort study was to investigate the prognostic impacts of drug-eluting stents (DES) and bare-metal stents (BMS) in patients undergoing percutaneous coronary intervention (PCI).

Methods: We conducted a retrospective cohort study based on the National Health Insurance program. Patients who had undergone coronary stenting between Jan. 2007 and Dec. 2008 were recruited and monitored until the end of 2010. Subjects with either BMS or DES were matched 2:1 by propensity score, which adjusted for age, sex, stent number and Charlson comorbidity index (CCI). The Kaplan-Meier method and Cox regression models were used for prognostic analyses.

Results: Among a total of 966 patients with a mean age of 66 years, 644 subjects had BMS and 322 subjects had DES. The incidence of myocardial infarction (MI) and death were significantly lower in the DES group as compared with the BMS group for the three-year follow-up duration. With adjustments for age, sex, premium-based monthly salary, levels of hospital care, stent number, CCI, medications, and acute coronary syndrome presentation in the index hospitalization, use of DES rather than BMS was associated with reduced adverse coronary events (hazard ratio and 95% confidence interval: 0.55, 0.38-0.81 in the whole population, and 0.44, 0.26-0.73 in the subgroup patients with stable coronary artery disease).

Conclusions: Implantation of DES was related to better outcomes than for BMS, in terms of reducing MI and mortality after PCI. The survival benefit for patients with DES was even greater in patients with stable coronary artery disease.

Keywords: Bare-metal stent; Drug-eluting stent; Propensity score.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The flow chart of patient selection. BMS, bare-metal stents; DES, drug-eluting stents.
Figure 2
Figure 2
Event-free survival analysis of adverse coronary events for patients with bare-metal stent (BMS) or drug-eluting stent (DES) after accounting for age, sex, premium-based monthly salary, levels of hospital care, Charlson comorbidity index, and whether or not acute coronary syndrome at index admission.
Figure 3
Figure 3
Survival analysis for patients with bare-metal stent (BMS) or drug-eluting stent (DES) after accounting for age, sex, premium-based monthly salary, levels of hospital care, Charlson comorbidity index, and whether or not acute coronary syndrome at index admission.
See this image and copyright information in PMC

References

    1. Finegold JA, Asaria P, Francis DP. Mortality from ischaemic heart disease by country, region, and age: statistics from World Health Organisation and United Nations. Int J Cardiol. 2013;168:934–945. - PMC - PubMed
    1. Lloyd-Jones D, Adams R, Carnethon M, et al. Heart disease and stroke statistics--2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009;119:e21–e181. - PubMed
    1. Babapulle MN, Joseph L, Bélisle P, et al. A hierarchical Bayesian meta-analysis of randomised clinical trials of drug-eluting stents. Lancet. 2004;364:583–591. - PubMed
    1. James SK, Stenestrand U, Lindback J, et al. Long-term safety and efficacy of drug-eluting versus bare-metal stents in Sweden. N Engl J Med. 2009;360:1933–1945. - PubMed
    1. Kastrati A, Dibra A, Spaulding C, et al. Meta-analysis of randomized trials on drug-eluting stents vs. bare-metal stents in patients with acute myocardial infarction. Eur Heart J. 2007;28:2706–2713. - PubMed

LinkOut - more resources