Published: 2018-12-26

Drug eluting stents versus bare metal stents in coronary artery disease patients: outcomes and complications

Veeraj Kalburgi


Background: To date, data regarding the long-term safety and efficacy of BMS and DES implantation in a real-world population are limited. Thus, this study was designed to study the complications, early and late outcomes of drug-eluting stents (DES) versus bare metal stents (BMS) after implantation in coronary artery disease (CAD) patients up to 6months follow-up period.

Methods: This was a single-center, hospital-based, prospective study conducted at a tertiary care center in India. Records of 250 patients who underwent percutaneous coronary intervention (PCI) in the period of January to December 2007 were included in the study. Early outcomes were indications of coronary angioplasty, length of hospital stay, Killip’s classification at presentation, type of coronary lesions, cath-lab outcomes and acute stent thrombosis (ST). Patients were clinically followed-up till hospital discharge, 30days and in 6months.

Results: Total 250 patients with an age range of 30-39years underwent PCI. Of the study population who underwent PCI 111 patients (44.4%) received DES, 104 patients (8%) received BMS, 20 patients received both DES and BMS and 15 patients underwent POBA, respectively. Complications like stroke and major bleeding were observed in 2 patients (0.8%) and 12 patients (4.8%) respectively. TIMI III flow and ST was observed in 215 patients (91.5%) and 6 patients (2.6%), respectively. Death was observed in 3 patients (1.2%) due to cardiogenic shock.

Conclusions: DES and BMS have good procedural success in achieving early revascularization with PCI. The incidence of ST was almost equal in DES compared to BMS.


Bare metal stents, Coronary artery disease, Drug eluting stents, Percutaneous coronary intervention

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Otikunta AN, Hosad UK, Reddy YS, Eruvaram S, Srinivas R, Garg R, et al. Analysis of 12Months Clinical outcomes associated with implantation of ultrathin (60μm) bare metal stent in an unselected real-world population with coronary artery disease. JCDR. 2017;11(5):OC12.

Grüntzig A. Transluminal dilatation of coronary-artery stenosis. Lancet. 1978;311(8058):263.

George BS, Roubin GS, Fearnot NE, Pinkerton CA, Raizner AE, King SB, et al. Multicenter investigation of coronary stenting to treat acute or threatened closure after percutaneous transluminal coronary angioplasty: clinical and angiographic outcomes. J Am Coll Cardiol. 1993;22(1):135-43.

King III SB. Why have stents replaced balloons? Underwhelming evidence. Ann Internal Med. 2003;138(10):842-3.

Kasturi S, Polasa S, Singh S, Reddy VK, Rao K, Mathan G, et al. Safety and efficacy of a novel everolimus-eluting stent system in “real-world” patients with coronary artery disease: a report of preliminary outcomes. World J Cardiovas Dis. 2016;6(12):458.

Vlaar PJ, de Smet BJ, Zijlstra F. DES or BMS in acute myocardial infarction? : Oxford Uni Press; 2007.

Lemos PA, Chandwani P, Saxena S, Ramachandran PK, Abhyankar A, Campos CM, et al. Clinical outcomes in 995 unselected real-world patients treated with an ultrathin biodegradable polymer-coated sirolimus-eluting stent: 12-month results from the FLEX Registry. BMJ. 2016;6(2):e010028.

Alidoosti MO, Salarifar MO, Haji-Zeinali AM, Kassaian SE, Dehkordi MR, Fathollahi MS. Clinical outcomes of drug-eluting stents compared with bare metal stents in our routine clinical practice. Hellenic J Cardiol. 2008;49(3):132-8.

Cutlip DE, Windecker S, Mehran R, Boam A, Cohen DJ, van Es GA, et al. Clinical end points in coronary stent trials: a case for standardized definitions. Circulation. 2007;115(17):2344-51.

Iakovou I, Mehran RO, Dangas GE. Thrombosis after implantation of drug-eluting stents. Hellenic J Cardiol. 2006;47:31-8.

Alidoosti M, Salarifar M, Zeinali AM, Kassaian SE, Dehkordi MR. Comparison of outcomes of percutaneous coronary intervention on proximal versus non-proximal left anterior descending coronary artery, proximal left circumflex, and proximal right coronary artery: a cross-sectional study. BMC Cardiovas Diss. 2007;7(1):7.

Lee CW, Park DW, Lee BK, Kim YH, Hong MK, Kim JJ, et al. Predictors of restenosis after placement of drug-eluting stents in one or more coronary arteries. Am J Cardiol 2006;97(4):506-11.

Ortolani P, Marzocchi A, Marrozzini C, Palmerini T, Saia F, Taglieri N, et al. Long-term effectiveness of early administration of glycoprotein IIb/IIIa agents to real-world patients undergoing primary percutaneous interventions: results of a registry study in an ST-elevation myocardial infarction network. Euro Heart J. 2008;30(1):33-43.

Sjauw KD, Engström AE, Vis MM, van der Schaaf RJ, Baan Jr J, Koch KT, et al. A systematic review and meta-analysis of intra-aortic balloon pump therapy in ST-elevation myocardial infarction: should we change the guidelines?. Euro Heart J. 2009;30(4):459-68.

Prewitt RM, Gu S, Schick U, Ducas J. Intraaortic balloon counterpulsation enhances coronary thrombolysis induced by intravenous administration of a thrombolytic agent. J Am Coll Cardiol. 1994;23(3):794-8.

Bouki KP, Pavlakis G, Papasteriadis E. Management of cardiogenic shock due to acute coronary syndromes. Angiol. 2005;56(2):123-30.

Van de Werf F, Ardissino D, Betriu A, Cokkinos DV, Falk E, Fox KA, et al. Management of acute myocardial infarction in patients presenting with ST-segment elevation. Euro Heart J. 2003;24(1):28-66.

de Man FH, Stella PR, Nathoe H, Kirkels H, Hamer B, Meijburg HW, et al. Stent thrombosis in real-world patients: a comparison of drug-eluting with bare metal stents. Netherlands Heart J. 2007;15(11):382-6.

Iakovou I, Schmidt T, Bonizzoni E, Ge L, Sangiorgi GM, Stankovic G, et al. Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents. JAMA. 2005;293:2126-30.

Spaulding C, Daemen J, Boersma E, Cutlip DE, Serruys PW. A pooled analysis of data comparing sirolimus-eluting stents with bare-metal stents. New Eng J Med. 2007;356(10):989-97.

Burzotta F, Parma A, Pristipino C, Manzoli A, Belloni F, Sardella G, et al. Angiographic and clinical outcome of invasively managed patients with thrombosed coronary bare metal or drug-eluting stents: the OPTIMIST study. Euro Heart J. 2008;29(24):3011-21.

Müller I, Besta F, Schulz C, Massberg S, Schönig A, Gawaz M. Prevalence of clopidogrel non-responders among patients with stable angina pectoris scheduled for elective coronary stent placement. Thrombosis Haemostasis. 2003;89(05):783-7.

Mohan S, Dhall A. A comparative study of restenosis rates in bare metal and drug-eluting stents. Inter J angiology Pub Inter Coll Angiol. 2010;19(2):e66.

Hermans WR, Rensing BJ, Kelder JC, de Feyter PJ, Serruys PW. Postangioplasty restenosis rate between segments of the major coronary arteries. Am J Cardiol. 1992;69(3):194-200.