Drug eluting stents better for SVG disease: ISAR-CABG trial

Drug eluting stents better for SVG disease: ISAR-CABG trial

Drug eluting stents better for SVG disease: ISAR-CABG trial: There was a concept that bare metal stents may fare equally well for saphenous vein graft disease as these are large conduits. ISAR-CABG was designed as a superiority trial to compare drug eluting stents with bare metal stents for saphenous vein graft lesions [1]. Three types of drug eluting stents (permanent-polymer paclitaxel-eluting stents, permanent-polymer sirolimus-eluting stents, or biodegradable-polymer sirolimus-eluting stents) or bare-metal stents were used in a ratio of 1:1:1:3. Total of 303 patients received drug-eluting stents and 307 patients received bare-metal stents. The combined incidence of death, myocardial infarction, and target lesion revascularization at 1 year was taken as the primary end point. The primary endpoint was noted in 15% in the drug eluting stent group and 22% in the bare metal stent group. Target lesion revascularization rate was lower for drug-eluting stents (7% vs 13%). There was no difference in the all cause mortality, which was 5% in each group and stent thrombosis was also similar, at 1%. The authors concluded that for de-novo saphenous vein graft lesions, drug eluting stents were better than bare metal stents.

Reference

  1. Julinda Mehilli, Jürgen Pache, Mohamed Abdel-Wahab, Stefanie Schulz, Robert A Byrne, Klaus Tiroch, Jörg Hausleiter, Melchior Seyfarth, Ilka Ott, Tareq Ibrahim, Massimiliano Fusaro, Karl-Ludwig Laugwitz, Steffen Massberg, Franz-Josef Neumann, Gert Richardt, Albert Schömig, Adnan Kastrati, Is Drug-Eluting-Stenting Associated with Improved Results in Coronary Artery Bypass Grafts? (ISAR-CABG) Investigators. Drug-eluting versus bare-metal stents in saphenous vein graft lesions (ISAR-CABG): a randomised controlled superiority trial. Lancet. 2011 Sep 17;378(9796):1071-8.