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Observational Study
. 2016 May;106(5):373-81.
doi: 10.5935/abc.20160043. Epub 2016 Apr 5.

First- Versus Second-Generation Drug-Eluting Stents in Acute Coronary Syndromes (Katowice-Zabrze Registry)

[Article in English, Portuguese]
Damian Kawecki  1 , Beata Morawiec  1 , Janusz Dola  1 , Wojciech Wanha  2 , Grzegorz Smolka  2 , Aleksandra Pluta  2 , Kamil Marcinkiewicz  2 , Andrzej Ochała  2 , Ewa Nowalany-Kozielska  1 , Wojciech Wojakowski  2
Affiliations
Observational Study

First- Versus Second-Generation Drug-Eluting Stents in Acute Coronary Syndromes (Katowice-Zabrze Registry)

[Article in English, Portuguese]
Damian Kawecki et al. Arq Bras Cardiol. 2016 May.

Erratum in

  • Erratum.
    Arq. Bras. Cardiol.. Arq. Bras. Cardiol.. Arq Bras Cardiol. 2016 May;106(5):452. doi: 10.5935/abc.20160075. Arq Bras Cardiol. 2016. PMID: 27305291 Free PMC article.
  • Erratum.
    [No authors listed] [No authors listed] Arq Bras Cardiol. 2016 Aug;107(2):191. doi: 10.5935/abc.20160121. Arq Bras Cardiol. 2016. PMID: 27627646 Free PMC article. No abstract available.

Abstract

Background: There are sparse data on the performance of different types of drug-eluting stents (DES) in acute and real-life setting.

Objective: The aim of the study was to compare the safety and efficacy of first- versus second-generation DES in patients with acute coronary syndromes (ACS).

Methods: This all-comer registry enrolled consecutive patients diagnosed with ACS and treated with percutaneous coronary intervention with the implantation of first- or second-generation DES in one-year follow-up. The primary efficacy endpoint was defined as major adverse cardiac and cerebrovascular event (MACCE), a composite of all-cause death, nonfatal myocardial infarction, target-vessel revascularization and stroke. The primary safety outcome was definite stent thrombosis (ST) at one year.

Results: From the total of 1916 patients enrolled into the registry, 1328 patients were diagnosed with ACS. Of them, 426 were treated with first- and 902 with second-generation DES. There was no significant difference in the incidence of MACCE between two types of DES at one year. The rate of acute and subacute ST was higher in first- vs. second-generation DES (1.6% vs. 0.1%, p < 0.001, and 1.2% vs. 0.2%, p = 0.025, respectively), but there was no difference regarding late ST (0.7% vs. 0.2%, respectively, p = 0.18) and gastrointestinal bleeding (2.1% vs. 1.1%, p = 0.21). In Cox regression, first-generation DES was an independent predictor for cumulative ST (HR 3.29 [1.30-8.31], p = 0.01).

Conclusions: In an all-comer registry of ACS, the one-year rate of MACCE was comparable in groups treated with first- and second-generation DES. The use of first-generation DES was associated with higher rates of acute and subacute ST and was an independent predictor of cumulative ST.

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Conflict of interest statement

Potential Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Temporal distribution of the number of first- and second-generation DES implanted during studied period. DES: drug-eluting stent.
Figure 2
Figure 2
Incidence of MACCE at 1 year. MACCE: major adverse cardiac and cerebrovascular events; DES: drug-eluting stents.
Figure 3
Figure 3
Stent thrombosis (ST) rates. ST: stent thrombosis; DES: drug-eluting stents.
See this image and copyright information in PMC

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