Comparative effectiveness at five years of drug-eluting stents, bare metal stents, and coronary bypass surgery: the ERACI III study

Boothroyd, DM; Mieres, JJ; Grinfeld, Liliana; Pereira, Carlos Fernández; Granillo, AM Rodríguez; Berrocal, Daniel; Palacios, IP; Neill, William O; Hlatky, M. A.; Rodríguez, Alfredo E.

doi:10.30567/raci/201203/0135-0142

Cited by 2 publications

(3 citation statements)

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“…In the ERACI III registry (Estudio Randomizado Argentino Angioplastia versus Cirugia) [30][31][32], we also found an increased incidence of death with DES beyond the first year in comparison with BMS or CABG groups; all causes of death at one year have been similar in the three groups. At 5 years, the ERACI III DES group had an increase in death either in comparison with BMS or CABG groups in the overall (1.84, 0.92-1.68, p = 0.08) and after adjusted population (2.53, 1.10,1.83, p = 0.03).…”

Section: Previous Old Safety Datamentioning

confidence: 54%

“…In fact, a reviewing article was written by us after a large observational study from New York was published in 2012 [ 25 , 26 ]; in such revision, we highlighted changes in the safety paradigm compared to CABG after the introduction of DES during PCI. However, at that time, we did not express concerns about non-cardiac-related death, and we were mainly focused on the role of late DES thrombosis as the main reason for those findings [ 30 , 31 , 32 ].…”

Section: Previous Old Safety Datamentioning

confidence: 99%

“…At 5 years, the ERACI III DES group had an increase in death either in comparison with BMS or CABG groups in the overall (1.84, 0.92–1.68, p = 0.08) and after adjusted population (2.53, 1.10,1.83, p = 0.03). Different adverse risk profiles among DES-treated patients cannot explain these differences, as multivariable statistical adjustment for baseline factors did not affect the results [ 30 , 31 , 32 ].…”

Section: Previous Old Safety Datamentioning

confidence: 99%

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High Non-Cardiac Death Incidence Should Be a Limitation of Drug-Eluting Stents Implantation? Insights from Recent Randomized Data

et al. 2023

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Despite the introduction of drug-eluting stents (DES) significantly improved the efficacy and safety of percutaneous coronary interventions (PCI), particularly in a high-risk group of patients, the gap between PCI with his competitor’s coronary artery bypass surgery (CABG) and/or optimal medical treatment alone was not reduced. In this revision, we highlighted the fact that in recent years landmark randomized studies reported at mid and long-term follow-ups a high incidence of non-cardiac death, cancer incidence, or both in the DES group of patients. The overall incidence of non-cardiac death was significantly higher in the DES vs. the comparator arm: 5.5% and 3.8%, respectively, p = 0.000018, and non-cardiac death appears to be more divergent between DES vs. the comparator at the extended follow-up to expenses of the last one. One of these trials reported five times greater cancer incidence in the DES arm at late follow-up, 5% vs. 0.7% p < 0.0018. We review the potential reason for these unexpected findings, although we can discard that DES biology could be involved in it. Until all these issues are resolved, we propose that DES implantation should be tailored accorded patient age, life expectancy, and lesion complexity.

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Section: Previous Old Safety Datamentioning

confidence: 54%