| Autor: |
de la Torre Hernández, José M., Alfonso, Fernando, Gimeno, Federico, Diarte, Jose A., Lopez-Palop, Ramón, Pérez de Prado, Armando, Rivero, Fernando, Sanchis, Juan, Larman, Mariano, Diaz, Jose F., Elizaga, Jaime, Moreiras, Javier Martín, Gomez Jaume, Alfredo, Hernández, José M., Mauri, Josepa, Recalde, Angel Sánchez, Bullones, Juan A., Rumoroso, Jose R., del Blanco, Bruno García, Baz, Jose A., Bosa, Francisco, Botas, Javier, Hernández, Felipe |
| Jazyk: |
angličtina |
| Předmět: |
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| Zdroj: |
JACC: Cardiovascular Interventions. (9):911-919 |
| ISSN: |
1936-8798 |
| DOI: |
10.1016/j.jcin.2010.06.010 |
| Popis: |
ObjectivesThis study sought to evaluate second-generation drug-eluting stent (DES) thrombosis in clinical practice.BackgroundFirst-generation DES are associated with a significant incidence of late thrombosis. There is paucity of data regarding real practice late thrombosis incidence and predictors with second-generation DES, zotarolimus-eluting stent (ZES), and everolimus-eluting stents (EES).MethodsA prospective, large-scale, non-industry-linked multicenter registry was designed. Complete clinical-procedural data and systematic follow-up of all patients treated with these stents was reported in a dedicated registry supported by the Spanish Working Group on Interventional Cardiology.ResultsFrom 2005 to 2008, 4,768 patients were included in 34 centers: 2,549 treated with ZES, and 2,219 with EES. The cumulative incidence of definite/probable thrombosis for ZES was 1.3% at 1 year and 1.7% at 2 years and for EES 1.4% at 1 year and 1.7% at 2 years (p = 0.8). The increment of definite thrombosis between the first and second year was 0.2% and 0.25%, respectively. In a propensity score analysis, the incidence remained very similar. Ejection fraction (adjusted hazard ratio [HR]: 0.97; 95% confidence interval [CI]: 0.95 to -0.99; p = 0.008), stent diameter (adjusted HR: 0.37; 95% CI: 0.17to 0.81; p = 0.01) and bifurcations (adjusted HR: 2.1; 95% CI: 1.14 to 3.7; p = 0.02) emerged as independent predictors of thrombosis. In the subgroup of patients with bifurcations, the use of ZES was independently associated with a higher thrombosis rate (adjusted HR: 4; 95% CI: 1.1 to 13; p = 0.03).ConclusionsIn a real practice setting, the incidence of thrombosis at 2 years with ZES and EES was low and quite similar. The incidence of very late thrombosis resulted lower than was reported in registries of first-generation DES. In the subset of bifurcations, the use of ZES significantly increased the risk of thrombosis. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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