Basel Kosten Effektivitäts Trial – SAphenous Venous Graft Angioplasty Using Glycoprotein 2b/3a Receptor Inhibitors and Drug-Eluting Stents - BASKET-SAVAGE

Contribution To Literature:

The BASKET-SAVAGE trial showed that drug-eluting stents reduce major adverse cardiac events in saphenous vein graft lesions.

Description:

The goal of the trial was to evaluate percutaneous coronary intervention (PCI) with a drug-eluting stent compared with a bare-metal stent among patients with a saphenous vein graft (SVG) lesion.

Study Design

  • Randomized
  • Parallel

Patients with a saphenous vein graft (SVG) lesion were randomized to a drug-eluting stent (Taxus Liberte; n = 89) versus a bare-metal stent (Liberte; n = 84). All patients were recommended to receive a glycoprotein IIb/IIIa inhibitor and a distal protection device (FilterWire) during PCI.

Inclusion criteria:

  • Patients with SVG stenosis undergoing PCI
  • Total number of enrollees: 173
  • Duration of follow-up: 36 months
  • Mean patient age: 72 years

The trial was terminated early due to slow enrollment.

Principal Findings:

The primary outcome, incidence of cardiac death, nonfatal myocardial infarction, or target vessel revascularization at 12 months, occurred in 2.3% of the drug-eluting stent group versus 17.9% of the bare-metal stent group (p < 0.001). The association remained the same in longer-term follow-up.

Secondary outcomes:

  • Stent thrombosis: 0 versus 4.8% (p = 0.09); respectively, for drug-eluting versus bare-metal stents
  • Major bleeding: 2.3% versus 2.4% (p = 0.91); respectively, for drug-eluting versus bare-metal stents

Interpretation:

Among patients with a SVG lesion, the use of a drug-eluting stent was associated with a reduction in major adverse events compared with a bare-metal stent. The risk of stent thrombosis and major bleeding were the same between treatment groups. The results of the DIVA trial are awaited.

References:

Presented by Dr. Raban Jeger at the European Society of Cardiology Congress, Rome, Italy, August 30, 2016.

Clinical Topics: Acute Coronary Syndromes, Invasive Cardiovascular Angiography and Intervention, Interventions and ACS

Keywords: Acute Coronary Syndrome, Angina Pectoris, Constriction, Pathologic, Drug-Eluting Stents, Hemorrhage, Myocardial Infarction, Percutaneous Coronary Intervention, Platelet Glycoprotein GPIIb-IIIa Complex, Saphenous Vein, Stents, Thrombosis, ESC Congress


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