title: Clinical outcomes of different first- and second-generation drug-eluting stents in routine clinical practice: results from the prospective multicenter German DES.DE registry.
abstract: BACKGROUND
  Second-generation drug-eluting stents (DES) have provided better results over both bare-metal stents and first-generation DES. However, comparative data of different first- and second-generation DES in a clinical setting of all-comers have not been well studied.
  
  
  RESULTS
  Baseline clinical and angiographic characteristics and in-hospital and follow-up events were recorded for enrolled patients. The composite of death, myocardial infarction, and stroke, defined as major adverse cardiac and cerebrovascular events (MACCE), as well as target vessel revascularization (TVR) was used as the primary end point. Between May 2007 and May 2009, 10,852 patients subjected to drug-eluting stent implantation were enrolled at 74 sites. 3,032 patients (27.9 %) were treated with Taxus™, 4,382 (40.4 %) with Cypher™, 1,012 (9.3 %) with Endeavor™, 1,693 (15.6 %) with Xience V™ and 733 (6.8 %) with Promus™ during this period. At 1-year follow-up, the comparison between groups revealed no significant differences with respect to overall death, MACCE, definite stent thrombosis, TVR, stroke and major bleeding. After adjustment for risk factors in final regression models, a modestly significant association of DES type to MACCE was observed (p = 0.046); however, this association could not be attributed to one particular DES. An impact of DES type on TVR was not seen after risk adjustment.
  
  
  CONCLUSIONS
  Data generated from the prospective German drug-eluting stent (DES.DE) registry confirm that safety and efficacy of different first- and second-generation DES are clinically equivalent in the first year of follow-up, even in a more complex setting.
authors: Divisions of Cardiology, Pulmology, Intensive Care Medicine, Department of Internal Medicine I, Heart Center Rostock, Rostock School of Medicine, University Hospital Rostock, Ernst-Heydemann-Str. 6, 18057 Rostock, Germany.
authors: Ibrahim
authors: I
authors: Akin
authors: Matthias
authors: M
authors: Hochadel
authors: Mohamed
authors: M
authors: Abdel-Wahab
authors: Jochen
authors: J
authors: Senges
authors: Gert
authors: G
authors: Richardt
authors: Steffen
authors: S
authors: Schneider
authors: Ulrich
authors: U
authors: Tebbe
authors: Karl-Heinz
authors: KH
authors: Kuck
authors: Christoph A
authors: CA
authors: Nienaber
mesh_terms: D000368:Aged; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D054855:Drug-Eluting Stents; D005260:Female; D005858:Germany; D006470:Hemorrhage / Q000209:etiology / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011474:Prosthesis Design; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000401:mortality; D013927:Thrombosis / Q000209:etiology / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents
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