Differences in lesion characteristics and patient background associated with the medium-term clinical outcomes of bare-metal and first-, second- and third-generation drug-eluting stents

Long-term results of myocardial revascularization in patients with multivessel disease

“…The groups did not differ signifi cantly in patient histories of cerebrovascular accident, myocardial infarction, arrhythmias, peripheral atherosclerotic vascular disease, or chronic obstructive pulmonary disease (COPD), and, therefore, the average value of the Charlson co-morbidity index (22,23) for stented and operated patients did not differ. According to the Syntax score, the PCI and CABG groups differed in the range of up to three points (respectively, 14 (10-17.8) vs 16.7 (13)(14)(15)(16)(17)(18)(19)(20), p = 0.01, for low SS; and 24.5 (23-27.5) vs 27.5 (24-30), p < 0.001 in the intermediate SS group), while in the intermediate SS group, the ratios of patients with two-or three-vessel disease were comparable. However, patients with three-vessel disease in the low SS group were more likely to undergo CABG than stenting (37 % and 24 %, p = 0.04) (Tab.…”

“…Importantly, it should be noted that the authors of earlier studies used previous-generation stents (4)(5)(6)(7)(8)(9)(10). Considering the introduction of a new generation of stents into clinical practice and the improvement in stenting technologies that have proven to be more effective (12)(13)(14) than previous approaches, one can expect a signifi cant improvement in long-term results with PCI. The authors of several studies have noted a signifi cant progression in atherosclerosis after CABG in arteries located proximal to the distal anastomosis (15,16), while other reports revealed occlusion of auto-venous bypasses after CABG of up to 45-50 % of cases by 8-10 years after the operation (15,16).…”