title: Five-year clinical results of coronary angioplasty with drug-eluting stents. National initiative in strategic innovation, iNOS.
abstract: BACKGROUND
  The use of drug-eluting stents (DES) is beneficial in patients undergoing percutaneous coronary intervention (PCI) and there is particular interest in long-term follow-up.
  
  
  OBJECTIVE
  We aimed to assess and characterize early DES use in Portugal during 2003 and patient follow-up over a 5-year period. We developed a web-based database to collect and organize patient and procedural data from PCI performed in ten cardiovascular interventional centers sharing the same database.
  
  
  METHODS
  This was a multicenter retrospective study that included 1833 consecutive angiographically successful coronary angioplasties in which a DES was implanted in 2003. A subgroup of patients with 5-year clinical follow-up after the initial procedure was selected for which there was at least a 90% follow-up rate during one quarter of 2003. Demographic, clinical and angiographic characteristics of the entire population were assessed. In the clinical follow-up cohort, the incidence of major adverse cardiac events (MACE)--death, myocardial infarction and surgical or percutaneous target lesion revascularization--was analyzed by survival curves and logistic regression analysis.
  
  
  RESULTS
  Of the total population, 23% were female, and mean age was 62 +/- 11 years (25-92). The main risk factors were hypertension (60.5%), dyslipidemia (42.9%), smoking (45.1%) and diabetes (23.9%, of whom 13.2% were on insulin therapy). There was a history of myocardial infarction, PCI or bypass surgery respectively in 23.1%, 25.1%, and 9.7% of the patients. Multivessel disease was present in 59.9% of patients (mean of 1.86 +/- 0.81 vessels). PCI was performed on average in 1.24 +/- 0.48 lesions, and complete revascularization in 58.8%. A total of 2058 stents were used (mean of 1.62 +/- 0.84) in 1271 patients. The longitudinal substudy included only 320 PCIs, for which follow-up was achieved in 319 (99%; median: 1875 days, P25: 1457 days, P75: 2045 days). Thirty-seven deaths (11.6%) and 61 MACE (19.1%) occurred in this group, with no differences between insulin-treated and other diabetic patients.
  
  
  CONCLUSIONS
  This is the first study to analyze the early Portuguese experience with drug-eluting stents. The clinical results compare favorably with the first published international registries. The on-line platform used was successful in collecting data in a standardized format on the clinical experience of multiple centers.
authors.affiliation: Unidade de Intervenção Cardiovascular, Hospital de Santa Cuz, Carnaxide. josebaptista@spc.pt
authors.forename: José
authors.initials: J
authors.lastname: Baptista
authors.forename: Rui Campante
authors.initials: RC
authors.lastname: Teles
authors.forename: Pedro Canas
authors.initials: PC
authors.lastname: da Silva
authors.forename: Hélder
authors.initials: H
authors.lastname: Pereira
authors.forename: Leitão
authors.initials: L
authors.lastname: Marques
authors.forename: Ricardo
authors.initials: R
authors.lastname: Santos
authors.forename: Henrique
authors.initials: H
authors.lastname: Carvalho
authors.forename: Dinis
authors.initials: D
authors.lastname: Martins
authors.forename: Pedro
authors.initials: P
authors.lastname: Farto e Abreu
authors.forename: Jorge
authors.initials: J
authors.lastname: Araújo
authors.forename: Rui Campante
authors.initials: RC
authors.lastname: Teles
authors.forename: Manuel
authors.initials: M
authors.lastname: Almeida
authors.forename: Luis
authors.initials: L
authors.lastname: Raposo
authors.forename: Pedro Canas
authors.initials: PC
authors.lastname: da Silva
authors.forename: Henrique Mesquita
authors.initials: HM
authors.lastname: Gabriel
authors.forename: Helder
authors.initials: H
authors.lastname: Pereira
authors.forename: Hugo
authors.initials: H
authors.lastname: Vinhas
authors.forename: António
authors.initials: A
authors.lastname: Leitão-Marques
authors.forename: Marco
authors.initials: M
authors.lastname: Costa
authors.forename: José
authors.initials: J
authors.lastname: Baptista
authors.forename: Ricardo
authors.initials: R
authors.lastname: Santos
authors.forename: Filipe
authors.initials: F
authors.lastname: Seixo
authors.forename: Pedro
authors.initials: P
authors.lastname: Farto e Abreu
authors.forename: Henrique
authors.initials: H
authors.lastname: Carvalho
authors.forename: André
authors.initials: A
authors.lastname: Luz
authors.forename: Dinis
authors.initials: D
authors.lastname: Martins
authors.forename: Jorge
authors.initials: J
authors.lastname: Araújo
authors.forename: Bruno
authors.initials: B
authors.lastname: Silva
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D003131:Combined Modality Therapy; D023921:Coronary Stenosis / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors