Long term clinical outcomes of brachytherapy, bare-metal stenting, and drug-eluting stenting for de novo and in-stent restenosis lesions: Five year follow-up

Abstract

BACKGROUND: We aimed to investigate the effects of brachytherapy, drug-eluting stent (DES)
and bare metal stent (BMS) applications in the treatment of coronary artery disease, on five-
-year clinical outcomes and mortality.

METHODS: Two hundred and seventeen patients who were treated in our clinics between
January 2000 and December 2003 with brachytherapy, DES, or BMS for both de novo and in-
-stent restenosis lesions were included in this cohort study. Of these 217 patients, 69 received
brachytherapy, 80 were given BMS and 68 were given DES. The clinical outcomes of the
patients during hospitalization and over a long-term follow-up were evaluated. Cardiovascular
events, revascularizations and mortality rates were compared among the three groups over
a five-year follow-up.

RESULTS: The mean age was 60.1 ± 9.5 years in the brachytherapy group, 55.7 ± 9.2 years in
the BMS group, and 58.9 ± 9.8 years in the DES group (p = 0.44). All-cause mortality rates
were 20 (29%) brachytherapy patients, 22 (27.5%) BMS patients, and four (5.9%) DES
patients (p = 0.01). Cardiovascular event was the cause of death for 14 (20.3%) brachytherapy
patients, 16 (20%) BMS patients and four (5.9%) DES patients (p = 0.001). All-cause
mortality rates were 20 (29%) brachytherapy patients, 22 (27.5%) BMS patients and four
(5.9%) DES patients. All-cause and cardiovascular mortality rates were significantly lower in the
DES group compared to both the BMS and the brachytherapy groups (p = 0.01 and p = 0.001,
respectively).

CONCLUSIONS: DES application for in-stent restenosis and de novo lesions was superior to
brachytherapy and BMS application with respect to all-cause and cardiovascular mortalities.
(Cardiol J 2011; 18, 6: 654–661)