title: First- Versus Second-Generation Drug-Eluting Stents in Acute Coronary Syndromes (Katowice-Zabrze Registry).
abstract: There are sparse data on the performance of different types of drug-eluting stents (DES) in acute and real-life setting.
  
  
  
  The aim of the study was to compare the safety and efficacy of first- versus second-generation DES in patients with acute coronary syndromes (ACS).
  
  
  
  This all-comer registry enrolled consecutive patients diagnosed with ACS and treated with percutaneous coronary intervention with the implantation of first- or second-generation DES in one-year follow-up. The primary efficacy endpoint was defined as major adverse cardiac and cerebrovascular event (MACCE), a composite of all-cause death, nonfatal myocardial infarction, target-vessel revascularization and stroke. The primary safety outcome was definite stent thrombosis (ST) at one year.
  
  
  
  From the total of 1916 patients enrolled into the registry, 1328 patients were diagnosed with ACS. Of them, 426 were treated with first- and 902 with second-generation DES. There was no significant difference in the incidence of MACCE between two types of DES at one year. The rate of acute and subacute ST was higher in first- vs. second-generation DES (1.6% vs. 0.1%, p < 0.001, and 1.2% vs. 0.2%, p = 0.025, respectively), but there was no difference regarding late ST (0.7% vs. 0.2%, respectively, p = 0.18) and gastrointestinal bleeding (2.1% vs. 1.1%, p = 0.21). In Cox regression, first-generation DES was an independent predictor for cumulative ST (HR 3.29 [1.30-8.31], p = 0.01).
  
  
  
  In an all-comer registry of ACS, the one-year rate of MACCE was comparable in groups treated with first- and second-generation DES. The use of first-generation DES was associated with higher rates of acute and subacute ST and was an independent predictor of cumulative ST.
authors.affiliation: 2, Zabrze Medical University of Silesia, Katowice, Poland.
authors.forename: Damian
authors.initials: D
authors.lastname: Kawecki
authors.affiliation: 2, Zabrze Medical University of Silesia, Katowice, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Morawiec
authors.affiliation: 2, Zabrze Medical University of Silesia, Katowice, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Dola
authors.affiliation: 3, Medical University of Silesia, Katowice, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Wanha
authors.affiliation: 3, Medical University of Silesia, Katowice, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Smolka
authors.affiliation: 3, Medical University of Silesia, Katowice, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Pluta
authors.affiliation: 3, Medical University of Silesia, Katowice, Poland.
authors.forename: Kamil
authors.initials: K
authors.lastname: Marcinkiewicz
authors.affiliation: 3, Medical University of Silesia, Katowice, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Ochała
authors.affiliation: 2, Zabrze Medical University of Silesia, Katowice, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Nowalany-Kozielska
authors.affiliation: 3, Medical University of Silesia, Katowice, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Wojakowski
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality / Q000601:surgery*; D000368:Aged; D002561:Cerebrovascular Disorders / Q000209:etiology* / Q000401:mortality; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011044:Poland / Q000453:epidemiology; D012042:Registries; D012189:Retrospective Studies; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents