Concurrent drug eluting/bare metal stent implantation during percutaneous coronary intervention in target vessel: outcomes and 1-year follow-up.

AIM

We aimed at analyzing the safety of concurrent drug eluting stent (DES)/bare metal stent (BMS) placement in the same target segment using the dataset of the German Drug Eluting Stent Registry (DES.DE).

METHODS AND RESULTS

In DES.DE a total of 5,296 patients either received concurrent BMS/DES (n = 526; 9.9%) or DES/DES stenting (n = 4,770; 90.1%) in the same target segment (5,407 segments). Patient and clinical characteristics were essentially similar in both groups. ACS was a positive adjusted predictor of BMS/DES concurrent stenting (OR 1.52; 95% CI 1.23-1.87) as was age (OR 1.14; 1.04-1.25). Negative predictors were in-stent stenosis (OR 0.49; 0.35-0.68), lesion length >20 mm (OR 0.62; 0.51-0.75), >85% stenosis prior to PCI (OR 0.68; 0.56-0.83) and cardiogenic shock (OR 0.29; 0.09-0.93). The in-hospital mortality in patients receiving BMS/DES concurrent stenting was higher than in those receiving DES/DES placement (OR 2.61; 95% CI 1.05-6.49). At the 12 months follow-up there were no statistical differences with respect to mortality (OR 0.94; 95% CI 0.55-1.61). However, the incidence of recurrent myocardial infarction (OR 1.86; 1.11-3.12) and target vessel revascularization (TVR) (OR 1.37; 1.06-1.76) was borderline to significantly higher in BMS/DES patients. Multivariable predictors of 1-year mortality were age, ACS, cardiogenic shock, renal insufficiency, PAD, heart failure and smoking.

CONCLUSIONS

Concurrent BMS/DES stenting is associated with an increase in in-hospital but not long-term mortality. Further, there was a significant increase in recurrent myocardial infarction and TVR, but absolute differences were low.