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Risk factors for clinical events at 1-year follow-up after drug-eluting stent implantation: results from the prospective multicenter German DES.DE registry

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Abstract

Background

Drug-eluting stents (DES) have substantially reduced target vessel revascularization (TVR) after percutaneous coronary interventions. Risk factors for clinical events need to be redefined with this treatment option.

Methods and results

In the prospective DES.DE registry, baseline clinical and angiographic characteristics as well as in-hospital and follow-up events were recorded for all enrolled patients. Between October 2005 and May 2009, 21,774 patients receiving DES were enrolled at 98 DES.DE sites. The composite of death, myocardial infarction (MI) and stroke defined as major adverse cardiac and cerebrovascular events (MACCE) and TVR were predefined as primary endpoints. At 1-year follow-up rates for overall death, MI, stroke, MACCE, TVR and definite stent thrombosis were 2.7, 3.1, 1.4, 7.1, 11.5 and 0.6 %, respectively. Aside from well-known risk factors like age, diabetes mellitus and triple-vessel disease, stratification in patients with or without MACCE revealed atrial fibrillation, non-ST-segment elevation myocardial infarction, renal failure, impaired ejection fraction and peripheral vascular disease as strong predictors of MACCE at 1 year.

Conclusion

Data collected in the DES.DE registry, reflecting the clinical practice in Germany, revealed favorable clinical outcomes after DES implantation in a real world setting but also identifying several high-risk populations.

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Authors and Affiliations

  1. Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Deutschland

    I. Akin

  2. Herzzentrum Rostock, Universitätsklinikum, Rostock, Deutschland

    C. A. Nienaber

  3. Herzzentrum, Segeberger Kliniken GmbH, Bad Segeberg, Deutschland

    G. Richardt & R. Tölg

  4. Institut für Herzinfarktforschung, Ludwigshafen, Deutschland

    M. Hochadel, S. Schneider & J. Senges

  5. Klinikum Lippe-Detmold, Detmold, Deutschland

    U. Tebbe

  6. Herzzentrum Ludwigshafen, Ludwigshafen, Deutschland

    U. Zeymer

  7. Elisabeth-Krankenhaus, Essen, Deutschland

    G. Sabin

  8. Asklepios Klinik St. Georg, Hamburg, Deutschland

    K. -H. Kuck & M. W. Bergmann

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  1. I. Akin
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  2. C. A. Nienaber
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Corresponding author

Correspondence to I. Akin.

Appendix

Appendix

Organization of the German DES.DE Registry

Members of the Steering Committee: Christoph A. Nienaber (Chairman), Karl-Heinz Kuck (Chairman), Christoph Bode, Fokko de Haan, Gert Richardt, Georg Sabin, Jochen Senges, Sigmund Silber, Jürgen Stumpf, Ulrich Tebbe, Stephan Willich, Thomas Fetsch, Gabriele Sailer, Steffen Schneider.

Members of the Clinical Event Committee: Bernhard Meier, Martin G. Gottwik.

Internet data acquisition (Institute of Clinical Research of the German Cardiac Society): Thomas Fetsch, Petra Kremer.

Statistical analysis (Heart Center Ludwigshafen): Steffen Schneider, Mathias Hochadel.

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Akin, I., Nienaber, C.A., Richardt, G. et al. Risk factors for clinical events at 1-year follow-up after drug-eluting stent implantation: results from the prospective multicenter German DES.DE registry. Clin Res Cardiol 103, 363–372 (2014). https://doi.org/10.1007/s00392-014-0662-x

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  • DOI: https://doi.org/10.1007/s00392-014-0662-x

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