Major adverse cardiac events in patients with hepatitis C infection treated with bare-metal versus drug-eluting stents.

Background: There are no data comparing the long-term outcome of bare-metal stents (BMS) vs drug-eluting stents (DES) in patients with hepatitis C virus (HCV) infection. Hypothesis: In patients with HCV infection, the rate of major adverse cardiac events (MACE) would be less, and the mortality rates similar, in patients treated with DES than in patients treated with BMS. Methods: The incidence of major adverse cardiac events (MACE) during long-term follow-up, including death, myocardial infarction, and target-vessel revascularization, was investigated in HCV-infected patients who also underwent percutaneous coronary intervention with bare-metal or drug-eluting stents. Results: Of 78 patients studied, BMS were placed in 41 patients and DES stents in 37 patients. Stepwise Cox regression analyses were performed to identify significant independent risk factors for MACE. At 42 +/- 11 month follow-up, MACE occurred in 9 of 41 patients (22%) in the BMS group (mean age 63 +/- 11 years, 66% men) vs in 7 of 37 patients (19%) in the DES group (mean age 61 +/- 9 years, 65% men). There was no significant difference in MACE in the BMS group vs the DES group. This persisted even after controlling for length of the stent, complexity of lesion, and other comorbidities. All-cause mortality was not significantly different in the BMS group vs the DES group (7% vs 5%). Conclusions: At long-term follow-up of HCV-infected patients with stable liver function, the rates of MACE and of all-cause mortality were similar in the BMS and DES groups.