Abstract 20483: Independent Predictors of Mace at Different Time Points After the Treatment of Non-Selected Patients With Drug-Eluting Stents: An Analysis of the Desire Registry
Introduction: Predictors of major adverse cardiac events (MACE = cardiac death, MI and target-lesion revascularization) at different time points after percutaneous coronary interventions (PCI) with drug-eluting stents (DES) are still not clear, especially of the events happening after the first year of follow-up.
Hypothesis: We sought to determine the independent predictors of MACE at short, mid and long-term clinical follow-up among unselected patients (pts) treated solely with drug-eluting stents (DES).
Methods: The DESIRE registry is a prospective, single-center registry with all consecutive pts treated solely with DES between May/2002 and Jun/2015. There are virtually no exclusion criteria, aiming to reflect our daily practice. A regression model was built to determine in-hospital MACE predictors while a multivariate model was built to determine independent predictors of MACE at two other time points: 1) between hospital discharge and 1 year, and; 2) long-term (>1 year) clinical follow-up.
Results: A total of 6,361 pts were enrolled. The mean age was 64 ± 11 years. DM was detected in 31.5% and 16.8% presented with STEMI. Follow-up was obtained in 98% of the patients (median 5.4 years). Predictors of MACE in the in-hospital phase were: age (OR 1.025, p=0.04), treatment of SVG (OR 1.8, p<0.01), stent length (1.02, p<0.01) and residual stenosis (1.03, p<0.01). Predictors of MACE between hospital discharge and 1 year FU were: age (HR 1.02, p=0.04), smoking (HR 1.98, p<0.01), renal insufficiency (HR 1.7, p=0.05), treatment of SVG (HR 3.0, p <0.01), stent length (HR 1.8, p <0.01), and residual stenosis (1.03, p<0.01). After the first year of PCI, predictors of MACE were: age (HR 1.01, p=0.04), smoking (HR 1.5, p <0.01), presence of peripheral vascular disease (HR 2.0, p =0.01), renal insufficiency (HR 1.7, p<0.01), treatment of SVG (HR 1.8, p <0.01) and treatment of patients with ACS (HR 1.7, p<0.01). Use of 2nd generation DES had a protective effect (HR 0.7, p=0.04)
Conclusion: In this real-world registry, advanced age, treatment of SVG and long lesions were predictors of MACE at all time points. The type of stent used (1st generation DES) and the initial clinical presentation (ACS) only impacted the occurrence of long-term negative events (>1 year).
Author Disclosures: J. Costa: None. A. Sousa: None. A. Moreira: None. R. Costa: None. M. Cano: None. G. maldonado: None. J. Sousa: None.
- © 2016 by American Heart Association, Inc.