Thrombosis of Second-Generation Drug-Eluting Stents in Real Practice Results From the Multicenter Spanish Registry ESTROFA-2 (Estudio Espanol Sobre Trombosis de Stents Farmacoactivos de Segunda Generacion-2)

被引：31

作者：

de la Torre Hernandez, Jose M. ^{[1
]}

Alfonso, Fernando ^{[2
]}

Gimeno, Federico ^{[7
]}

Diarte, Jose A. ^{[8
]}

Lopez-Palop, Ramon ^{[9
]}

Perez de Prado, Armando ^{[10
]}

Rivero, Fernando ^{[3
]}

Sanchis, Juan ^{[11
]}

Larman, Mariano ^{[12
]}

Diaz, Jose F. ^{[13
,16
]}

Elizaga, Jaime ^{[4
]}

Martin Moreiras, Javier ^{[14
]}

Gomez Jaume, Alfredo ^{[15
]}

Hernandez, Jose M.

Mauri, Josepa ^{[18
]}

Sanchez Recalde, Angel ^{[5
]}

Bullones, Juan A. ^{[17
]}

Rumoroso, Jose R. ^{[19
]}

Garcia del Blanco, Bruno ^{[20
]}

Baz, Jose A. ^{[21
]}

Bosa, Francisco ^{[22
]}

Botas, Javier ^{[23
]}

Hernandez, Felipe ^{[6
]}

机构：

[1] Hosp Univ Marques Valdecilla, Unidad Hemodinam & Cardiol Intervencionista, Inst Formac & Invest Marques Valdecilla, Intervent Cardiol Dept, Santander 39012, Spain

[2] Hosp Clinico San Carlos, Intervent Cardiol Dept, Madrid, Spain

[3] Hosp La Princesa, Intervent Cardiol Dept, Madrid, Spain

[4] Hosp Gregorio Maranon, Intervent Cardiol Dept, Madrid, Spain

[5] Hosp La Paz, Intervent Cardiol Dept, Madrid, Spain

[6] Hosp 12 Octubre, Intervent Cardiol Dept, E-28041 Madrid, Spain

[7] Hosp Clin Valladolid, Intervent Cardiol Dept, Valladolid, Spain

[8] Hosp Miguel Servet, Intervent Cardiol Dept, Zaragoza, Spain

[9] Hosp San Juan Alicante, Intervent Cardiol Dept, Alicante, Spain

[10] Hosp Leon, Intervent Cardiol Dept, Leon, Spain

[11] Hosp Clin Valencia, Intervent Cardiol Dept, Valencia, Spain

[12] Policlin Guipuzcoa, Intervent Cardiol Dept, San Sebastian, Spain

[13] Hosp Juan Ramon Jimenez, Intervent Cardiol Dept, Huelva, Spain

[14] Hosp Clin Salamanca, Intervent Cardiol Dept, Salamanca, Spain

[15] Hosp Son Dureta, Intervent Cardiol Dept, Palma de Mallorca, Spain

[16] Hosp Virgen La Victoria, Intervent Cardiol Dept, Malaga, Spain

[17] Hosp Carlos Haya, Intervent Cardiol Dept, Malaga, Spain

[18] Hosp Badalona Germans Trias & Pujol, Intervent Cardiol Dept, Badalona, Spain

[19] Hosp Galdacano, Intervent Cardiol Dept, Bilbao, Spain

[20] Hosp Vail dHebron, Intervent Cardiol Dept, Barcelona, Spain

[21] Hosp Meixoeiro, Intervent Cardiol Dept, Vigo, Spain

[22] Hosp Clin Tenerife, Intervent Cardiol Dept, Santa Cruz de Tenerife, Spain

[23] Fdn Alcorcon, Intervent Cardiol Dept, Alcorcon, Spain

来源：

JACC-CARDIOVASCULAR INTERVENTIONS | 2010年 / 3卷 / 09期

关键词：

coronary; stents; thrombosis; CORONARY-ARTERY-DISEASE; LARGE 2-INSTITUTIONAL COHORT; ROUTINE CLINICAL-PRACTICE; ENDEAVOR-II; FOLLOW-UP; TRIAL; OUTCOMES; LESIONS; SAFETY; EFFICACY;

D O I：

10.1016/j.jcin.2010.06.010

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives This study sought to evaluate second-generation drug-eluting stent (DES) thrombosis in clinical practice. Background First-generation DES are associated with a significant incidence of late thrombosis. There is paucity of data regarding real practice late thrombosis incidence and predictors with second-generation DES, zotarolimus-eluting stent (ZES), and everolimus-eluting stents (EES). Methods A prospective, large-scale, non-industry-linked multicenter registry was designed. Complete clinical-procedural data and systematic follow-up of all patients treated with these stents was reported in a dedicated registry supported by the Spanish Working Group on Interventional Cardiology. Results From 2005 to 2008, 4,768 patients were included in 34 centers: 2,549 treated with ZES, and 2,219 with EES. The cumulative incidence of definite/probable thrombosis for ZES was 1.3% at 1 year and 1.7% at 2 years and for EES 1.4% at 1 year and 1.7% at 2 years (p = 0.8). The increment of definite thrombosis between the first and second year was 0.2% and 0.25%, respectively. In a propensity score analysis, the incidence remained very similar. Ejection fraction (adjusted hazard ratio [HR]: 0.97; 95% confidence interval [CI]: 0.95 to -0.99; p = 0.008), stent diameter (adjusted HR: 0.37; 95% CI: 0.17to 0.81; p = 0.01) and bifurcations (adjusted HR: 2.1; 95% CI: 1.14 to 3.7; p = 0.02) emerged as independent predictors of thrombosis. In the subgroup of patients with bifurcations, the use of ZES was independently associated with a higher thrombosis rate (adjusted HR: 4; 95% Cl: 1.1 to 13; p = 0.03). Conclusions In a real practice setting, the incidence of thrombosis at 2 years with ZES and EES was low and quite similar. The incidence of very late thrombosis resulted lower than was reported in registries of first-generation DES. In the subset of bifurcations, the use of ZES significantly increased the risk of thrombosis. (J Am Coll Cardiol Intv 2010;3:911-9) (C) 2010 by the American College of Cardiology Foundation

引用

页码：911 / 919

页数：9

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