4. Discussion
cardiac deaths
REGRESSION, CARDIOGENIC SHOCK, CARDIAC DEATHS, STENOSES
In our trial, we performed a retrospective analysis of an all-comers patient population in the clinic of Memmingen over a period of six years who received an SVG intervention either by SExS (Both patient groups (SExS and BExS) did not differ significantly regarding baseline characteristics and were therefore comparable. Of note, patients treated by SExS had slightly more comorbidities (MACE rates in our BExS group were higher than in previous studies such as the ISAR-CABG or BASKET-SAVAGE trial. However, patients presenting with a cardiogenic shock or previous stent implantation or patients under oral anticoagulation were excluded in these trials. In contrast, in our study, we performed an all-comers analysis with no patient exclusions. This may explain the higher MACE-rates regarding the BExS patient group [On the other hand, we were able to demonstrate that patients treated by SExS had a significantly lower MACE rate after 30 days follow up than patients treated by BExS (2.0% vs. 12.5%, The main finding of our study was that after one-year follow-up, the MACE rate was still significantly lower in the SExS group than in the BExS group (15.7% vs. 35.7%, Another major finding of our study was the following: Although the number of cardiac deaths was similarly low in both groups (SExS: Cox regression analysis of risk factor covariates revealed several risk factors with hazard ratios >1, as well as protective factors (hazard ratio <1), however only one was significant: history of previous CABG treatment resulted in a higher one-year MACE rate in both patient groups as compared to de-novo SVG intervention (In summary, our results suggest a potential benefit of SExS treatment in SVG stenoses. SExS may have a positive impact on the patient outcome, in particular by increasing cumulative survival and lowering incidence of the MACE rate.Several limitations need to be mentioned. Our trial was a retrospective analysis of a single center only. The number of patients included in both groups was relatively small, due to the low incidence of patients in need of SVG intervention. The pre- and post-dilatation rates were overall higher within the SExS patient group. We only performed the analysis over a period of one-year follow-up. Post-procedural cardiac markers were not regularly acquired. Of note, the SExS tested in our study is currently no longer available (STENTYS-SES®).