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Concurrent drug eluting/bare metal stent implantation during percutaneous coronary intervention in target vessel: outcomes and 1-year follow-up

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Clinical Research in Cardiology Aims and scope Submit manuscript

Abstract

Aim

We aimed at analyzing the safety of concurrent drug eluting stent (DES)/bare metal stent (BMS) placement in the same target segment using the dataset of the German Drug Eluting Stent Registry (DES.DE).

Methods and results

In DES.DE a total of 5,296 patients either received concurrent BMS/DES (n = 526; 9.9%) or DES/DES stenting (n = 4,770; 90.1%) in the same target segment (5,407 segments). Patient and clinical characteristics were essentially similar in both groups. ACS was a positive adjusted predictor of BMS/DES concurrent stenting (OR 1.52; 95% CI 1.23–1.87) as was age (OR 1.14; 1.04–1.25). Negative predictors were in-stent stenosis (OR 0.49; 0.35–0.68), lesion length >20 mm (OR 0.62; 0.51–0.75), >85% stenosis prior to PCI (OR 0.68; 0.56–0.83) and cardiogenic shock (OR 0.29; 0.09–0.93). The in-hospital mortality in patients receiving BMS/DES concurrent stenting was higher than in those receiving DES/DES placement (OR 2.61; 95% CI 1.05–6.49). At the 12 months follow-up there were no statistical differences with respect to mortality (OR 0.94; 95% CI 0.55–1.61). However, the incidence of recurrent myocardial infarction (OR 1.86; 1.11–3.12) and target vessel revascularization (TVR) (OR 1.37; 1.06–1.76) was borderline to significantly higher in BMS/DES patients. Multivariable predictors of 1-year mortality were age, ACS, cardiogenic shock, renal insufficiency, PAD, heart failure and smoking.

Conclusions

Concurrent BMS/DES stenting is associated with an increase in in-hospital but not long-term mortality. Further, there was a significant increase in recurrent myocardial infarction and TVR, but absolute differences were low.

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Conflict of interest

The study was sponsored by an unrestricted educational grant of Sanofi-Aventis, Cordis, Boston Scientific, and Medtronic. There is no further conflict of interest to disclose for the authors of this publication.

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Authors and Affiliations

  1. Abteilung für Kardiologie, Asklepios Klinik St-Georg, Hamburg, Germany

    Alessandro Cuneo & Karl-Heinz Kuck

  2. Department I, Cardiology, Angiology, Intensive Care Medicine, Klinikum Lippe-Detmold, Detmold, Germany

    Alessandro Cuneo & Ulrich Tebbe

  3. Institut für Pharmakologie und präventive Medizin, Mahlow, Germany

    Peter Bramlage

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

    Matthias Hochadel & Jochen Senges

  5. Klinik und Poliklinik für Innere Medizin, Abteilung für Kardiologie, Universität Rostock, Rostock, Germany

    Christoph Nienaber

  6. Fachbereich Herz-Kreislauf, Klinikum Lippe GmbH, Röntgenstrasse 18, 32756, Detmold, Germany

    Ulrich Tebbe

Authors
  1. Alessandro Cuneo
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  2. Peter Bramlage
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  3. Matthias Hochadel
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  4. Jochen Senges
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  5. Christoph Nienaber
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  6. Karl-Heinz Kuck
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  7. Ulrich Tebbe
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Corresponding author

Correspondence to Ulrich Tebbe.

Additional information

For the DES.DE Study Group. The members of the DES.DE Study Group are listed in “Appendix”.

Appendix

Appendix

Dr. Van Birgelen, Eschede; Prof. Dr. Christoph Bode, Freiburg; Prof. Dr. Tassilo Bonzel, Fulda; Dr. Fokko de Haan, Solingen; Prof. Dr. Karl-Heinz Kuck, Hamburg; Prof. Dr. Christoph Nienaber Rostock; Prof. Dr. G.V. Sabin, Essen; Prof. Dr. Heinz-Peter Schultheiss, Berlin; Prof. Dr. Sigmund Silber, München; Prof. Dr. Ulrich Tebbe, Detmold.

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Cuneo, A., Bramlage, P., Hochadel, M. et al. Concurrent drug eluting/bare metal stent implantation during percutaneous coronary intervention in target vessel: outcomes and 1-year follow-up. Clin Res Cardiol 101, 281–288 (2012). https://doi.org/10.1007/s00392-011-0390-4

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  • DOI: https://doi.org/10.1007/s00392-011-0390-4

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