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Clinical outcomes of different first- and second-generation drug-eluting stents in routine clinical practice: results from the prospective multicenter German DES.DE registry

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Abstract

Background

Second-generation drug-eluting stents (DES) have provided better results over both bare-metal stents and first-generation DES. However, comparative data of different first- and second-generation DES in a clinical setting of all-comers have not been well studied.

Methods and results

Baseline clinical and angiographic characteristics and in-hospital and follow-up events were recorded for enrolled patients. The composite of death, myocardial infarction, and stroke, defined as major adverse cardiac and cerebrovascular events (MACCE), as well as target vessel revascularization (TVR) was used as the primary end point. Between May 2007 and May 2009, 10,852 patients subjected to drug-eluting stent implantation were enrolled at 74 sites. 3,032 patients (27.9 %) were treated with Taxus™, 4,382 (40.4 %) with Cypher™, 1,012 (9.3 %) with Endeavor™, 1,693 (15.6 %) with Xience V™ and 733 (6.8 %) with Promus™ during this period. At 1-year follow-up, the comparison between groups revealed no significant differences with respect to overall death, MACCE, definite stent thrombosis, TVR, stroke and major bleeding. After adjustment for risk factors in final regression models, a modestly significant association of DES type to MACCE was observed (p = 0.046); however, this association could not be attributed to one particular DES. An impact of DES type on TVR was not seen after risk adjustment.

Conclusion

Data generated from the prospective German drug-eluting stent (DES.DE) registry confirm that safety and efficacy of different first- and second-generation DES are clinically equivalent in the first year of follow-up, even in a more complex setting.

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Conflict of interest

No conflict of interest expressed by all authors.

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Authors and Affiliations

  1. Divisions of Cardiology, Pulmology, Intensive Care Medicine, Department of Internal Medicine I, Heart Center Rostock, Rostock School of Medicine, University Hospital Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany

    Ibrahim Akin & Christoph A. Nienaber

  2. IHF, Ludwigshafen, Germany

    Matthias Hochadel, Jochen Senges & Steffen Schneider

  3. Department of Cardiology, Heart Center, Bad Segeberg, Germany

    Mohamed Abdel-Wahab & Gert Richardt

  4. Department of Cardiology, Hospital Detmold, Detmold, Germany

    Ulrich Tebbe

  5. Department of Cardiology, Asklepios Hospital, Hamburg, Germany

    Karl-Heinz Kuck

Authors
  1. Ibrahim Akin
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  2. Matthias Hochadel
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  3. Mohamed Abdel-Wahab
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  4. Jochen Senges
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  5. Gert Richardt
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  6. Steffen Schneider
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  7. Ulrich Tebbe
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  8. Karl-Heinz Kuck
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  9. Christoph A. Nienaber
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Corresponding author

Correspondence to Christoph A. Nienaber.

Additional information

For the DES.DE Study Group.

Appendix: Organization of the DES.DE registry

Appendix: Organization of the DES.DE registry

Members of the Steering Committee:

 Christoph A. Nienaber (Chairman), Karl-Heinz Kuck (Chairman), Christoph Bode, Fokko de Haan, Gert Richardt, Georg Sabin, Jochen Senges, Sigmund Silber, Jürgen Stumpf, Ulrich Tebbe, Stephan Willich, Thomas Fetsch, Gabriele Sailer, Steffen Schneider.

Members of the Clinical Event Committee:

Bernhard Meier and Martin G Gottwick.

Internet data acquisition (Institute of Clinical Research of the German Cardiac Society): Thomas Fetsch, Petra Kremer.

Statistical analysis (Heart Center Ludwigshafen):

Steffen Schneider, Matthias Hochadel.

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Akin, I., Hochadel, M., Abdel-Wahab, M. et al. Clinical outcomes of different first- and second-generation drug-eluting stents in routine clinical practice: results from the prospective multicenter German DES.DE registry. Clin Res Cardiol 102, 371–381 (2013). https://doi.org/10.1007/s00392-013-0546-5

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