Abstract 13933: Comparison of First-Generation and Second-Generation Drug Eluting Stents in Real-World Acute Coronary Syndrome Population - Data from Zabrze-Katowice Registry
Purpose: To assess the safety and efficacy of 1st generation versus 2nd generation drug eluting stents (DES) in the real-world population of acute coronary syndromes (ACS).
Methods: The study included patients with ACS treated with either 1st generation (paclitaxel, sirolimus) or 2nd generation (everolimus, zotarolimus, biolimus) DES. The efficacy was determined by major adverse cardiac and cerebrovascular event (MACCE) at 1 year and included death, myocardial infarction, repeat revascularization and stroke. The safety was defined as stent thrombosis (ST) at 1 year.
Results: In the Registry, ACS was diagnosed in 1328 patients: 131 STEMI (9.9%), 285 NSTEMI (21.4%) and 912 UA (68.7%). Of them, 426 patients were treated with 1st generation DES and 902 patients with 2nd generation DES. Groups were similar regarding clinical characteristics. The ACC/AHA lesion type was equal and the Syntax score was significantly higher in 1st generation DES (p<0.001), and was <22 in both groups. No difference in the occurrence of MACCE was found. ST was more frequent in 1st generation than in 2nd generation DES (1.6% vs. 0.1%; p<0.001 for acute ST; 1.2% vs. 0.2%; p=0.025 for subacute ST; 0.7% vs. 0.2%; p=0.18 for late ST and 3.5% vs. 0.6%; p<0.0001 for cumulative ST) (Figure). In the multivariate logistic regression none of the angiographic and procedural parameters influenced MACCE and ST in both groups.
Conclusions: In the real-world population of ACS the use of 1st generation DES is equally efficient but saddled with lower safety profile than the use of 2nd generation DES independently of angiographic findings and procedure related bias.
Author Disclosures: D. Kawecki: None. B. Morawiec: None. J. Dola: None. W. Wanha: None. A. Pluta: None. K. Marcinkiewicz: None. A. Ochala: None. M. Tendera: None. E. Nowalany-Kozielska: None. W. Wojakowski: None.
- © 2014 by American Heart Association, Inc.