Long-term clinical outcomes of the Drug-Eluting Stents in the Real World (DESIRE) Registry.
BACKGROUND
Recently, cardiologists have treated more complex patients and lesions with drug-eluting stents (DES). However, long-term efficacy and safety of the off-label use of these new devices is yet to be demonstrated.


METHODS
The Drug-Eluting Stents in the Real World (DESIRE) registry is a prospective, nonrandomized single-center registry with consecutive patients treated solely with DES between May 2002 and May 2007. The primary end-point was long-term occurrence of major adverse cardiac events (MACE). Patients were clinically evaluated at 1, 3, and 6 months and then annually up to 5 years.


RESULTS
A total of 2,084 patients (2,864 lesions and 3,120 DES) were included. The mean age was 63.8 +/- 11.5 years. Diabetes was detected in 28.9% and 40.7% presented with acute coronary syndrome. Cyphertrade mark was the predominant DES in this registry (83.5%). Mean follow-up time was 2.6 +/- 1.2 years and was obtained in 96.5% of the eligible patients. Target lesion revascularization (TLR) was performed in 3.3% of the patients. Q wave myocardial infarction (MI) occurred in only 0.7% of these patients and total stent thrombosis rate was 1.6% (n = 33). Independent predictors of thrombosis were PCI in the setting of MI (HR 11.2; 95% CI, 9.6-12.4, P = 0.001), lesion length (HR 4.6; 95% CI, 3.2-5.3, P = 0.031), moderate to severe calcification at lesion site (HR 13.1; 95% CI, 12.1-16.7, P < 0.001), and in-stent residual stenosis (HR 14.5; 95% CI, 10.2-17.6, P < 0.001).


CONCLUSIONS
The use of DES in unselected population is associated with long-term safety and effectiveness with acceptable low rates of adverse clinical events.
Sousa
Amanda
A
Hospital do Coração-Associacao do Sanatorio Sirio, São Paulo, São Paulo, Brazil.
Costa
J Ribamar
JR
Moreira
Adriana C
AC
Cano
Manuel
M
Maldonado
Galo
G
Costa
Ricardo A
RA
Pavanello
Ricardo
R
Romano
Edson R
ER
Campos
Cantidio
C
Haddad
Nagib
N
Abizaid
Alexandre
A
Feres
Fausto
F
Mattos
Luiz Alberto
LA
Staico
Rodolfo
R
Sousa
J Eduardo
JE