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Drug eluting stents for the treatment of small vessels: very late experience (up to 7 years) of the DESIRE Registry

BACKGROUND: In this study, we sought to evaluate the clinical outcomes of patients with coronary lesions in small vessels in a cohort of real world patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES). METHODS: Between May 2002 and December 2009, 1,380 consecutive patients from the DESIRE Registry (Drug Eluting Stents In The Real World), with 1,683 lesions in small vessels (< 2.5 mm in diameter) were consecutively submitted to elective or emergency PCI, with 1,818 DES (CypherTM, 89%; TaxusTM, 7.5%; Xience V TM/PromusTM, 3%; Endeavor, 0.33%; BiomatrixTM, 0.2%) and included in this study. The clinical follow-up of up to 7 years (median, 2.8 years) was completed for 98%, and was obtained at 1, 6, 12 months and then annually. Our objective was to determine the rates of major cardiac events (MACE) during clinical follow-up. RESULTS: Mean age was 64.5 ± 11.7 years, with a prevalence of male patients (76.7%). Diabetes mellitus was observed in 31.6% of the cases and 9.8% had chronic renal failure. Left anterior descending artery was the most frequent vessel treated (43.4%) and two-thirds of the lesions were complex lesions (B2/C). Angiographic success was obtained in 98.8% of the cases. The rate of MACE was 12.8% during follow-up with 4.5% of cardiac death, 4.2% of acute myocardial infarction, 4.5% of repeat target lesion revascularization and 1.5% of stent thrombosis. CONCLUSIONS: In the DESIRE Registry, the use of DES to treat small vessels in non-selected patients was associated with excellent early and late outcomes and low thrombosis rates.

Drug-eluting stents; Angioplasty, transluminal, percutaneous coronary; Coronary restenosis


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