Author + information
- José de Ribamar Costa,
- Amanda Sousa,
- Adriana Moreira,
- Ricado Costa,
- Manuel Cano,
- Galo Maldonado,
- Cantidio Campos,
- Enilto Egito,
- Ricardo Pavanelo and
- J Eduardo Sousa
Despite the extensive knowledge accrued on DES in the past years, there is still lack of consistent data on the very late outcomes of these devices, especially after 5 years of their implantation. We sought to provide the longest clinical follow–up data on outcomes of unselected patients treated solely with DES
The DESIRE registry is a prospective, single–center registry encompassing all consecutive patients treated solely with DES since May 2002. The primary goal is the very long–term occurrence of MACE and stent thrombosis (ST). Patients were clinically followed at 1, 6 and 12 months and then annually.
A total of 4,000 patients were included. The mean age was 64 ± 11 years. DM was detected in 29.7% and 44.8% presented with acute coronary syndrome. Follow–up was obtained in 98.5% of the patients (median 5.6 years). Currently, 79.6% of the population is free of any MACE. TVR was performed in 5.3% of the patients. Q–wave MI rate was only 1.7% while total ST rate was 1.9%. The majority of definite ST cases occurred between the 1st and 3rd years. Independent predictors of MACE were treatment of SVG (HR 1,63; 95% CI, 1.22 to 2.18, p= 0.001), multivessel disease (HR 1.39; 95% CI, 1.03 to 1.87, p<0.001), residual stenosis (HR 1.3; 95% CI, 1.1 to 1.5, p= 0.034), DM (HR 1.6; 95% CI, 1.1 to 2.2, p= 0.006) and renal insufficiency (HR 1.5; 95% CI, 1.34 to 1.81, p= 0.004). Independent predictors of ST were PCI for STEMI (HR 3.5; 95% CI, 1.3 to 9.4, p= 0.013), stent length (HR 1.8; 95% CI, 1.09 to 3.02, p=0.023), moderate/severe calcification at lesion site (HR 2.38; 95% CI, 1.34 to 4.23, p=0.003), and in–stent residual stenosis (HR 1.04; 95% CI, 1.01 to 1.06, p=0.003).
The DESIRE registry probably represents the longest FU of a real world cohort treated solely with DES. In our single center experience, the use of DES was associated with very long–term safety and effectiveness with acceptable low rates of adverse clinical events, including ST. Also, there was no steady annual increment in the occurrence of ST, with a marked decrease of this complication after the 3rd year of FU.
West, Room 2001
Sunday, March 10, 2013, 9:15 a.m.–9:25 a.m.
Session Title: Drug–Eluting Stents
Abstract Category: 43. TCT@ACC–i2: Complex Patients, Diabetes, Renal Insufficiency
Presentation Number: 2903–11
- 2013 American College of Cardiology Foundation