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Long-term follow-up after coronary stenting with the sirolimus-eluting stent in clinical practice: results from the prospective multi-center German Cypher Stent Registry

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Abstract

Aims

To obtain long-term follow-up data of the sirolimus-eluting coronary stent (SES) and to determine factors associated with clinical events and target vessel revascularization (TVR).

Methods and results

Between 2002 and 2005, 5,946 patients were treated with at least one SES. A follow-up after a median of 4.1 years was obtained in 5,247 patients (88.2 %). During the follow-up, death occurred in 9.2 % of patients, nonfatal myocardial infarction in 5.9 %, nonfatal stroke in 2.2 % and MACCE (death/myocardial infarction/stroke) in 16.3 %. Any TVR was performed in 20.3 %. Independent predictors of MACCE were: older age (p < 0.0001), renal insufficiency (p < 0.0001), prior myocardial infarction (p < 0.0001), diabetes mellitus (p < 0.0001), cardiogenic shock (p = 0.0002), three-vessel disease (p = 0.0012), reduced left ventricular function (p = 0.0048), target vessel = bypass graft (p = 0.0122), indication for treatment = ACS (p = 0.0181) and PCI before implantation (p = 0.0308). Independent predictors of TVR were target vessel = coronary bypass (<0.0001), two- or three-vessel disease (p < 0.0001), ostial lesions (p < 0.0001), total length of SES implanted (p = 0.0012) and older age being a protective factor (p = 0.0187).

Conclusions

Long-term follow-up of the SES in clinical practice showed clinical event rates that were comparable to randomized trials with a MACCE rate of 16.3 % and TVR rate of 20.3 %.

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Conflict of interest

All authors, with the exception of Dr. Büttner/Prof. Neumann received travel expenses and/or payment for taking part at meetings of the steering committee of the Cypher Registry from Cordis. Mr. Pfannebecker is an employee of Cordis.

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Authors and Affiliations

  1. Kardiologie/Pneumologie/Angiologie/Internistische Intensivmedizin, Herzzentrum Ludwigshafen, Kardiologie, Bremserstraße 79, 67063, Ludwigshafen, Germany

    Ralf Zahn

  2. Herzzentrum, Abteilung für Kardiologie, Bad Krozingen, Germany

    Franz-Josef Neumann & Heinz-Joachim Büttner

  3. Segeberger Kliniken, Kardiologie, Bad Segeberg, Germany

    Gert Richardt

  4. Institut für Herzinfarktforschung Ludwigshafen an der Universität Heidelberg, Heidelberg, Germany

    Steffen Schneider

  5. Kardiologische Praxis, Berlin, Germany

    Benny Levenson

  6. Klinikum Lippe-Detmold, Kardiologie, Detmold, Germany

    Ulrich Tebbe

  7. Elisabeth Krankenhaus, Kardiologie, Essen, Germany

    Georg Sabin

  8. Universitätsklinikum, Kardiologie, Rostock, Germany

    Christoph A. Nienaber

  9. Cordis Corporation, Norderstedt, Germany

    Thomas Pfannebecker

  10. Kerckhoff Klinik, Kardiologie, Bad Nauheim, Germany

    Christian W. Hamm

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  1. Ralf Zahn
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  2. Franz-Josef Neumann
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  3. Heinz-Joachim Büttner
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  4. Gert Richardt
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  5. Steffen Schneider
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  7. Ulrich Tebbe
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  8. Georg Sabin
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  9. Christoph A. Nienaber
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  10. Thomas Pfannebecker
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  11. Christian W. Hamm
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Corresponding author

Correspondence to Ralf Zahn.

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For the German Cypher Stent Registry.

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Zahn, R., Neumann, FJ., Büttner, HJ. et al. Long-term follow-up after coronary stenting with the sirolimus-eluting stent in clinical practice: results from the prospective multi-center German Cypher Stent Registry. Clin Res Cardiol 101, 709–716 (2012). https://doi.org/10.1007/s00392-012-0448-y

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  • DOI: https://doi.org/10.1007/s00392-012-0448-y

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