Clinical Outcomes After Sirolimus-Eluting, Paclitaxel-Eluting, and Bare Metal Stents (from the First Phase of the Prospective Multicenter German DES.DE Registry)

• Published in: The American journal of cardiology 2009-11, Vol.104 (10), p.1362-1369
• Main Authors: Nienaber, Christoph A., MD, PhD, Akin, Ibrahim, MD, Schneider, Steffen, PhD, Senges, Jochen, MD, PhD, Fetsch, Thomas, MD, Tebbe, Ulrich, MD, PhD, Willich, Stefan N., MD, PhD, Stumpf, Jürgen, MD, Sabin, Georg V., MD, PhD, Silber, Sigmund, MD, PhD, Richardt, Gert, MD, PhD, Kuck, Karl-Heinz, MD, PhD
• Format: Article
• Language: English
• Subjects: Aged; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular Agents - administration & dosage; Cardiovascular disease; Clinical outcomes; Coronary Artery Disease - epidemiology; Coronary Artery Disease - therapy; Coronary Occlusion - epidemiology; Coronary Occlusion - therapy; Coronary Thrombosis - epidemiology; Drug-Eluting Stents; Female; Follow-Up Studies; Germany - epidemiology; Heart rate; Humans; Male; Medical sciences; Middle Aged; Myocardial Infarction - epidemiology; Myocardial Revascularization - statistics & numerical data; Paclitaxel - administration & dosage; Pharmacology. Drug treatments; Platelet Aggregation Inhibitors - therapeutic use; Prospective Studies; Registries; Sirolimus - administration & dosage; Stents; Stroke - epidemiology
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2009.06.058

The prospective multicenter German Drug-Eluting Stent ( DES.DE ) registry is an observational study to analyze and evaluate the therapeutic principle of the differential drug-eluting stents (sirolimus- and paclitaxel-eluting stents) and bare metal stents under real world conditions in the context of the German healthcare system. The baseline clinical and angiographic characteristics and follow-up events for 1 year were recorded for all enrolled patients. In addition, a health economics assessment was performed at 3, 6, 9, and 12 months after initial stent placement. The composite of death, myocardial infarction, and stroke, defined as major adverse cardiac and cerebrovascular events, and target vessel revascularization were used as the primary objectives. From October 2005 to October 2006, 6,384 patients were enrolled (sirolimus-eluting stents, n = 2,137; paclitaxel-eluting stents, n = 2,740; bare metal stents, n = 485) at 98 Deutsches Drug-Eluting Stent Register sites. With similar baseline clinical and descriptive morphology of coronary artery disease between both drug-eluting stent groups, no differences were present at 1 year of follow-up in the rates of overall mortality (3.8% vs 4.1%), target vessel revascularization (10.4% vs 10.4%), overall stent thrombosis (3.6% vs 3.8%), and major adverse cardiac and cerebrovascular events (8.1% vs 8.0%). Compared with the bare metal stent group, patients treated with drug-eluting stents had significantly lower rates of myocardial infarction (3.2% vs 6.0%; p