title: Borderline trend towards long-term mortality benefit from drug eluting stents implantation in ST-elevation myocardial infarction patients in Poland-data from NRDES registry.
abstract: OBJECTIVE
  To analyze long-term outcome of ST-Elevation Myocardial Infarction (STEMI) and non-STEMI (NSTEMI) patients treated with Drug Eluting Stents (DES) stents with regard to mortality and stent thrombosis rates based on the national Polish PCI registry database.
  
  
  BACKGROUND
  Only a few studies suggested potential trend towards lower mortality in STEMI patients treated with DES. Current European Society of Cardiology STEMI guidelines recommend DES use only with one restriction to suspected patient poor compliance or contraindication to dual antiplatelet therapy.
  
  
  METHODS
  Thirteen high-volume interventional cardiology centers in Poland enrolled patients in National Registry of Drug Eluting Stents (NRDES) Registry from October 2010 till October 2011.
  
  
  RESULTS
  There were 2686 patients enrolled in NRDES Registry. Eighty five patients (3%) had both DES and BMS implanted at index PCI procedure and were excluded from further analysis. A subpopulation of STEMI (1709; 66%) and NSTEMI (892; 34%) patients was selected for BMS vs DES comparison. A significant difference in favor of DES group for 1-year mortality was found in STEMI subgroup (P < 0.0001-unadjusted and P = 0.0497 after propensity score adjustment). No such differences were noticed for NSTEMI subgroup or stent thrombosis comparisons.
  
  
  CONCLUSIONS
  A strong selection bias for DES stents was observed with regard to demographic and angiographic characteristics in both STEMI and NSTEMI. DES implantation was associated with similar ischemic outcome to BMS at 1-year follow-up. STEMI patients with DES presented a trend towards lower long-term mortality at 1 year in comparison to BMS.
authors.affiliation: Department of Interventional Cardiology at University Hospital, JUMC in Krakow, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Siudak
authors.forename: Artur
authors.initials: A
authors.lastname: Dziewierz
authors.forename: Tomasz
authors.initials: T
authors.lastname: Rakowski
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Żmudka
authors.forename: Jacek
authors.initials: J
authors.lastname: Legutko
authors.forename: Stanisław
authors.initials: S
authors.lastname: Bartuś
authors.forename: Jacek
authors.initials: J
authors.lastname: Dragan
authors.forename: Wojciech
authors.initials: W
authors.lastname: Zasada
authors.forename: Tomasz
authors.initials: T
authors.lastname: Tokarek
authors.forename: Tomasz
authors.initials: T
authors.lastname: Kułaga
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Partyka
authors.forename: Dariusz
authors.initials: D
authors.lastname: Dudek
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000209:etiology / Q000401:mortality; D003328:Coronary Thrombosis / Q000209:etiology / Q000401:mortality; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011044:Poland; D057216:Propensity Score; D012042:Registries; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008670:Metals; D010975:Platelet Aggregation Inhibitors
keywords: acute coronary syndrome; restenosis; thrombosis