BEST: Similar mortality among angioplasty with DES (everolimus) and surgery

This observational registry compared the results of myocardial revascularization with angioplasty performed using everolimus-eluting stents in patients with multivessel. The primary endpoint of the study was mortality from any cause. Side end points were infarction, stroke, and revascularization. Propensity score was used to compare populations. Between 34819 patients were eligible 9223 patients in each group for the final analysis after using propensity score. Mean follow-up was 2.9 years observed that multivessel angioplasty with everolimus-eluting stents had similar mortality to surgery (3.1% per year versus 2.9% per year; p = 0.5). Regarding side end points a higher rate of infarction (1.9% versus 1.1%; p<0.001) and a greater rate of

repeat revascularization (7.2% versus 3.1%; p <0.001) with angioplasty, but minor incidence of stroke (0.7% versus 1%; p <0.001). The difference in acute myocardial infarction that favored surgery was observed only in patients with incomplete revascularization.

Conclusion

The risk of death in patients with multivessel angioplasty is similar between everolimus-eluting stents and surgery in this contemporary record.

Bangalore S.
2015-03-18

Original title: Everolimus-Eluting Stents or Bypass Surgery for Multivessel Coronary Disease.

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