Author + information
- 1University Tuebingen/Cardiology, Tuebingen, Germany
- 2Medizinische Klinik III, Universtaet Tuebingen
- 3Cardiovascular Disease and Medical Intensive Care Unit, Karl-Olga-Krankenhaus, Affiliated Hospital University of Ulm
- 4Medizinische Klinik III/Kardiologie und Kreislauferkrankungen, Universitätsklinikum Tübingen
- 5Tubingen University Hospital, Stuttgart, Germany
Our aim was to investigate the clinical outcome after implantation of Platinum-chromium (PtCr-EES, Promus Element) and cobalt chromium everolimus-eluting stents (CoCr-EES, Xience Prime) in an all-comer population.
698 consecutive patients (mean age 68.4 ± 10.8 years, male patients 73.6%, Diabetes mellitus DM 33.9%, STEMI 9.9%, NSTEMI 18.1%) underwent percutaneous coronary intervention (PCI) with either CoCr-EES (n=349) or PtCr-EES (n=349) in 2 consecutive time periods. Major adverse cardiac events MACE (death, myocardial infarction Ml, definite stent thrombosis ST an target lesion revascularization cTLR) were analysed after 30-days, 1 year und 3 years according to Academic Research Consortium (ARC) definitions. Primary end point of the study was clinically driven Target Lesion Revascularization (cTLR) after 12 months.
349 consecutive patients received CoCr-EES (avg. Diam 3.1 ± 0.4 mm, avg. 1.9 ± 1.1 stents/patient) and 349 received PtCr-EES (avg. Diam 3.1 ± 0.4 mm, avg. 1.8 ± 1.0 stents/patient). 30-day clinical outcome did not differ significantly between groups (death CoCrEES 1.4%, PtCr 3.4%, Ml 0.3% vs. 0.6%, ST 0.3 vs. 0.3%) . After 1 year clinically driven TLR was significally more present in patients receiving PtCr-EES (7.5%) than in patients receiving CoCr-EES (2.9%, Fig.1) ‘ whereas death (5.7 vs. 4.6%), MI (3.15 vs. 2.3%)n and ST (0.6 vs. 0.3%) did not differ between groups. Multivariate analysis of the entire study population revealed DM and use of PtCr-EES as only independent predictors of C-TLR (relative risk: 2,645 (95% Cl: 1.381 - 5.064, p = 0.003).
The safety profiles of PCI using PtCr-EES and CoCr-EES were similar while cTLR was significantly increased 1 year and 3 years after PtCr-EES implantation. Metallic Stent design and composition plays a significant role for clinical longterm outcome after PCI with EES.
CORONARY: Stents: Drug-Eluting