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Long-term clinical outcomes of drug eluting stents: safety and efficacy up to five years of the DESIRE Registry

BACKGROUND: Indications for the implantation of sirolimusand paclitaxel-eluting stents are expanding and include complex lesions and subsets of patients with clinical and demographic characteristics very different from those of early pivotal randomized trials. The DESIRE Registry was planned to monitor the safety of both Cypher® and Taxus® stent available in Brazil since 2002. METHODS AND RESULTS: From May 2002 through March 2007, 2043 patients treated with one or more than one stent (either Cypher® or Taxus®) at Hospital do Coração da Associação do Sanatório Sírio were included in this Registry. Mean age was 63.8 (11.3) years; 76.6% were male and 28.4% had diabetes. A total of 2,415 lesions were treated and 2,983 stents were implanted: 2,608 Cypher® and 375 Taxus®. Acute and subacute (<30 days); late thrombosis (31 days - 360 days) and very late thrombosis (>360 days) occurred in 0.34%, 0.73% and 0.34% of the patients, adding up to a 1.42% overall rate. Likewise, the major adverse cardiac event rate was low and added up to 8.6% (154 patients), including: 45 (2.51%) cardiac deaths; 50 (2.8%) myocardial infarctions and 59 (3.3%) of additional revascularizations. CONCLUSIONS: This long-term analysis of the DESIRE Registry shows the high efficacy and safety profiles of drug-eluting stents, with a low thrombosis rate, which is similar to those of randomized trials.

Stents, adverse effects; Angioplasty, transluminal, percutaneous coronary; Thrombosis; Treatment outcome


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