Effects of Coronary Artery Revascularization with a Polymer-Free Biolimus A9–Coated BioFreedom Stent Versus Bypass Surgery before Noncardiac Surgery.
10.3349/ymj.2018.59.4.480
- Author:
Kyu KIM
1
;
Choongki KIM
;
Byeong Keuk KIM
;
Ji Yong JANG
;
Ae Young HER
;
Seunghwan KIM
;
Sung Jin HONG
;
Chul Min AHN
;
Jung Sun KIM
;
Young Guk KO
;
Donghoon CHOI
;
Myeong Ki HONG
;
Yangsoo JANG
Author Information
1. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea. kimbk@yuhs.ac
- Publication Type:Multicenter Study ; Original Article
- Keywords:
Percutaneous coronary intervention;
drug-coated stent;
coronary artery bypass;
preoperative care
- MeSH:
Coronary Artery Bypass;
Coronary Artery Disease;
Coronary Vessels*;
Drug-Eluting Stents;
Health Care Costs;
Hospitalization;
Humans;
Length of Stay;
Myocardial Infarction;
Percutaneous Coronary Intervention;
Preoperative Care;
Stents*;
Stroke;
Thrombosis;
Transplants
- From:Yonsei Medical Journal
2018;59(4):480-488
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The present study aimed to evaluate the efficacy and safety of polymer-free drug-coated BioFreedom stent implantation in comparison to coronary artery bypass graft (CABG) before major noncardiac surgery. MATERIALS AND METHODS: In a multicenter registry, 55 patients required revascularization before major noncardiac surgery that should not be delayed >6 months. Of them, 27 underwent BioFreedom stent implantation and 28 underwent CABG. Primary outcomes included rate of noncardiac surgery, time from revascularization to noncardiac surgery, and occurrence of composite outcomes (all-cause death, myocardial infarction, stent thrombosis, stroke, repeat revascularization, or major bleeding). RESULTS: The rate of major noncardiac surgery was significantly higher in the BioFreedom group (92.6%) than in the CABG group (64.3%; p=0.027). Time from revascularization to noncardiac surgery was significantly shorter in the BioFreedom group (38.0 days) than in the CABG group (73.0 days; p=0.042). During the hospitalization for revascularization period, the occurrence of primary outcomes did not differ between the groups. However, the BioFreedom group showed a shorter hospitalization period and lower total treatment cost than the CABG group. During the hospital stay for noncardiac surgery, the occurrence of composite outcome was not significantly different between groups (4% vs. 0%; p>0.999): stroke occurred in only 1 case, and there were no cases of death or stent thrombosis in the BioFreedom group. CONCLUSION: This study demonstrated that BioFreedom stenting as a revascularization strategy before major noncardiac surgery might be feasible and safe in selected patients with less severe coronary artery diseases.
