Survival advantage in Medicare patients receiving drug‐eluting stents compared with bare metal stents: Real or artefactual?

Concerns have been raised regarding late mortality, particularly from late stent thrombosis, from drug‐eluting stents (DES). Randomized clinical trials have shown that DES decrease restenosis but do not decrease mortality compared with bare metal stents (BMS). These studies utilized well‐defined clinical and angiographic subsets. In the “real world” drug‐eluting stents are used in a much broader crosssection of patients. We evaluated mortality in the first year after implantation of DES, specifically the sirolimus‐eluting stent (SES), Cypher vs. BMS in “real world” older patients using the Medicare claims database.

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