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Cobalt–chrome MULTI-LINK VISION™-stent implantation in diabetics and complex lesions: results from the DaVinci-Registry

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Abstract

Aims

Restenosis in bare-metal stents is in part related to stent design and material. Optimized strut design of cobalt–chrome (CoCr) stents may yield nearly comparable results to drug-eluting stents (DES) in selected lesions. The prospective multicenter DaVinci registry investigates the clinical outcome of a CoCr coronary stent (MULTI-LINK VISION™), particularly in terms of patients with diabetes and complex lesions (B1, B2, C).

Methods and results

The prospective internet-based registry included 1,344 patients (76% males, aged 66 ± 10 years) undergoing stent implantation (n = 1,642) in 32 centres from July 2003 to June 2004. Follow-up data (median 9 ± 1 months) of this cohort were available for 1,289 patients (98.1%). Of these patients 327 (26.2%) were diabetics. In total, 1,429 de-novo lesions (A 11.9%, B1 47.7%, B2 31.6%, C 8.8%) were treated with the CoCr stent. The predefined primary endpoint was defined as a composite of death, Q-wave myocardial infarction (STEMI), non-STEMI (NSTEMI), target vessel revascularization (TVR) by coronary bypass graft (CABG) or PCI at 270 days (target vessel failure, TVF). Secondary endpoints include death, time to the first myocardial infarction, TVR and CABG. The cumulative incidence of major adverse cardiac events (MACE) was 12.4% with 0.8% deaths, 1.5% non-fatal MI, and 9.7% TVR. TVF in the overall cohort was documented in 137 (10.8%) patients. For diabetics and complex lesions TVF was 13.8% (95% CI 4.2–18) and 11.4% (95% CI 2.0–13.3), respectively.

Conclusion

This large registry confirms good acute and long-term success of CoCr stents making this strategy valuable, particularly in a special cohort (diabetics and complex lesions) as long as late stent thrombosis with DES plays a role and short-term antiplatelet therapy is favoured.

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Authors and Affiliations

  1. Department of Cardiology, Kerckhoff Heart Center, Benekestr. 2-8, 61231, Bad Nauheim, Germany

    Holger M. Nef, Helge Möllmann, Michael Weber & Christian W. Hamm

  2. Innere Medizin II, Kreiskrankenhaus Bergstrasse, 64646, Heppenheim, Germany

    Wolfgang Auch-Schwelk

  3. Medizinische Klinik I, Klinikum Fulda gAG, 36013, Fulda, Germany

    Tassilo Bonzel

  4. Kardiologische Gemeinschaftspraxis, 90491, Nürnberg, Germany

    Joanis Varelas

  5. Klinik für Herz- und Gefäßkrankheiten, Katharinenhospital, 70022, Stuttgart, Germany

    Thomas K. Nordt

  6. Medizinisches Versorgungszentrum Prof. Mathey, Prof. Schofer, Universitäres Herzzentrum Hamburg, 22527, Hamburg, Germany

    Joachim Schofer

  7. Herzzentrum Bernau, Abteilung Kardiologie, 16321, Bernau, Germany

    Hans-Heinrich Minden

  8. Praxisklinik Herz und Gefäße, 01099, Dresden, Germany

    Jürgen Stumpf

  9. Institut für Herzinfarkforschung, University of Heidelberg, 67056, Ludwigshafen, Germany

    Steffen Schneider

  10. Department of Cardiology, Klinikum Oldenburg, 26133, Oldenburg, Germany

    Albrecht Elsässer

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  1. Holger M. Nef
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  2. Helge Möllmann
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  11. Steffen Schneider
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  13. Christian W. Hamm
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Corresponding author

Correspondence to Holger M. Nef.

Additional information

Christian Hamm for the DaVinci-Investigators.

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Nef, H.M., Möllmann, H., Weber, M. et al. Cobalt–chrome MULTI-LINK VISION™-stent implantation in diabetics and complex lesions: results from the DaVinci-Registry. Clin Res Cardiol 98, 731–737 (2009). https://doi.org/10.1007/s00392-009-0061-x

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  • DOI: https://doi.org/10.1007/s00392-009-0061-x

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