title: Concurrent drug eluting/bare metal stent implantation during percutaneous coronary intervention in target vessel: outcomes and 1-year follow-up.
abstract: OBJECTIVE
  We aimed at analyzing the safety of concurrent drug eluting stent (DES)/bare metal stent (BMS) placement in the same target segment using the dataset of the German Drug Eluting Stent Registry (DES.DE).
  
  
  RESULTS
  In DES.DE a total of 5,296 patients either received concurrent BMS/DES (n = 526; 9.9%) or DES/DES stenting (n = 4,770; 90.1%) in the same target segment (5,407 segments). Patient and clinical characteristics were essentially similar in both groups. ACS was a positive adjusted predictor of BMS/DES concurrent stenting (OR 1.52; 95% CI 1.23-1.87) as was age (OR 1.14; 1.04-1.25). Negative predictors were in-stent stenosis (OR 0.49; 0.35-0.68), lesion length >20 mm (OR 0.62; 0.51-0.75), >85% stenosis prior to PCI (OR 0.68; 0.56-0.83) and cardiogenic shock (OR 0.29; 0.09-0.93). The in-hospital mortality in patients receiving BMS/DES concurrent stenting was higher than in those receiving DES/DES placement (OR 2.61; 95% CI 1.05-6.49). At the 12 months follow-up there were no statistical differences with respect to mortality (OR 0.94; 95% CI 0.55-1.61). However, the incidence of recurrent myocardial infarction (OR 1.86; 1.11-3.12) and target vessel revascularization (TVR) (OR 1.37; 1.06-1.76) was borderline to significantly higher in BMS/DES patients. Multivariable predictors of 1-year mortality were age, ACS, cardiogenic shock, renal insufficiency, PAD, heart failure and smoking.
  
  
  CONCLUSIONS
  Concurrent BMS/DES stenting is associated with an increase in in-hospital but not long-term mortality. Further, there was a significant increase in recurrent myocardial infarction and TVR, but absolute differences were low.
authors.affiliation: Abteilung für Kardiologie, Asklepios Klinik St-Georg, Hamburg, Germany. a.cuneo@asklepios.com
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cuneo
authors.forename: Peter
authors.initials: P
authors.lastname: Bramlage
authors.forename: Matthias
authors.initials: M
authors.lastname: Hochadel
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
authors.forename: Christoph
authors.initials: C
authors.lastname: Nienaber
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
authors.forename: Ulrich
authors.initials: U
authors.lastname: Tebbe
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D003324:Coronary Artery Disease / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D009204:Myocardial Revascularization / Q000379:methods; D012042:Registries; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome