Safety of drug-eluting stents in patients with left ventricular dysfunction undergoing percutaneous coronary intervention.
Am J Cardiol. 2008 Sep 15;102(6):679-82
Authors: Nusca A, Lipinski MJ, Varma A, Appleton DL, Goudreau E, Cowley MJ, Wittkamp MJ, Di Sciascio G, Vetrovec GW, Abbate A
Recent studies have reported a higher incidence of late stent thrombosis in patients undergoing drug-eluting stent (DES). Reduced left ventricular (LV) ejection fraction (EF) is considered a risk factor for this complication after both bare-metal stent (BMS) and DES implantation. Therefore, the aim of this study was to evaluate the safety of DES on long-term follow-up in patients with LV dysfunction undergoing percutaneous coronary intervention. We retrospectively selected all patients with an EF <45% undergoing percutaneous coronary intervention with implantation of >/=1 sirolimus- or paclitaxel-eluting stent at our institution. The primary endpoint of the study was all-cause mortality, retrieved using both Social Security Database and hospital records. We also compared the results of this group with a historical cohort of patients with LV dysfunction undergoing BMS implantation; 121 patients who received >/=1 DES were enrolled. The mean LVEF was 36 +/- 8%, with 20 patients (16%) with a LVEF </=25%; 36 patients (30%) had diabetes mellitus, and DES implantation was considered off-label in 100 patients (83%). Survival at 1-, 2-, and 3-year follow-up was 94% (95% confidence interval [CI] 88 to 100), 90% (95% CI 82 to 98) and 88% (95% CI 80 to 96), respectively. In conclusion, the favorable results of this study demonstrate the safety of DES in patients with LV dysfunction.
PMID: 18773987 [PubMed - in process]