Interv Akut Kardiol. 2007;6(2):50-55

Does drug eluting stent increase long-term mortality?Results of prospective Liberec registry

František Holm, David Horák, Radomír Šimek, Zdeněk Šembera, Vladimír Hraboš

Kardiologické oddělení, Krajská nemocnice Liberec

Use of drug eluting stents (DES) decrease incidence of in-stent restenosis (ISR). However, mortality and non-fatal myocardial infarction (MI) is not influenced. Last year, there appeared first information on possibly higher incidence of death/MI due to late stent thrombosis.

Aim of study and method: Analysis of long-term results of prospective non-randomized registry of patients treated by implantation of sirolimus eluting stent (SES). Primary end-point was total mortality, target lesion revascularization (TLR) and clinical in-stent restenosis. The patients were followed-up only clinically and coronary angiography was not performed routinely, only in the case of clinical suspicion on in-stent restenosis.

Demographics: 151 patients after SES implantation were followed-up to 22,6 (18–24) months in average. Mean age was 57 years. Risk factors were present as follows: arterial hypertension in 70 %, hyperlipidaemia in 48 %, diabetes mellitus in 25 %, previous MI in 41 %, smoking in 34 %. 36 % of patients presented with acute coronary syndrome. Dual antiplatelet therapy (aspirin plus clopidogrel) was administrated for 3 month in majority of patients.

Results: There were implanted 184 SES of average size 3,06 × 22,2 mm. Target lesion was treated in left anterior descendent artery in 65 % and right coronary artery in 16 %. Total mortality was 2 %, cardiac mortality 2 %, however no patient died due to early or late complication with SES implantation. Clinical in-stent restenosis occured in 4 (2,7 %) paitents and was confirmed angiographicaly. In-stent thrombosis was present in 1 (0,7 %) patient in this group of ISR. Following target lesion revascularization was performed in 3 (2 %) patients. Average time of occurence of clinical ISR/IST was 17,3 months from SES implantation.

Conclusion: Results of long-term follow-up of patients with SES show very low incidence of clinically driven ISR followed by TLR. Long-term mortality was as well very low. No relation between SES implantation and mortality was found. Limitation of this registry is relatively low number of patients, on the other hand our results are valuable to long-term follow-up in non-selected population in the real world.

Key words: drug eluting stent, death, clinical in-stent restenosis, target lesion revascularization.

Keywords: drug eluting stent, death, clinical in-stent restenosis, target lesion revascularization

Published: June 1, 2007  Show citation