Abstract 2538: Long-Term (up to 6 years) Clinical Outcomes of Patients with Impact of Chronic Kidney Disease in the Treated with Drug-eluting Stents. Insights from the Drug Eluting Stents In the REal World(DESIRE) Registry

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Adriana Moreira ◽  
Amanda Sousa ◽  
José Costa ◽  
Ricardo Costa ◽  
Manuel Cano ◽  
...  

Background: Chronic renal disease has been consistently shown to be an independent predictor of poorer long-term clinical outcomes after percutaneous treatment of coronary artery disease, even in DES era. We sought to evaluate the very long-term clinical outcome after DES implantation in this high risk subset in a real world cenario. Methods and Results: Between May/2002 and Jan/2007, 2,043 pts treated exclusively with DES were consecutively enrolled in the non-randomized, single-center DESIRE Registry. Recent myocardial infarction (72h), saphenous venous graft and patients with < 6months follow-up were excluded. The remaining pts (n=1500) were divided into 2 groups according to their creatinine clearence: Group I -Clearance ≤ 60 (n= 490) and Group II- clearance >60 (n= 1010). Primary endpoint included combined MACE and stent thrombosis (ST) rate. ST was classified according to ARC definitions. Clinical follow-up was obtained at 1, 3 and 6 months and then annually up to 6 years. Follow-up was achieved in 98% of the eligible cohort (median 3.6 years). Baseline characteristics and late outcomes are displayed in the table . Conclusions: In the DESIRE registry the negative impact of renal dysfunction was considerably minimized by the use of DES, resulting in very low and equivalent rates of myocardial infarction, TLR and ST when compared to patients with preserved renal condition. We especulate that the higher mortality among these very complex pts may reflect the severity of their comorbities.

2008 ◽  
Vol 21 (4) ◽  
pp. 307-314 ◽  
Author(s):  
AMANDA SOUSA ◽  
J. RIBAMAR COSTA, Jr ◽  
ADRIANA C. MOREIRA ◽  
MANUEL CANO ◽  
GALO MALDONADO ◽  
...  

2021 ◽  
Vol 10 (16) ◽  
pp. 3642
Author(s):  
Sungmin Lim ◽  
Eun Ho Choo ◽  
Ik Jun Choi ◽  
Kwan Yong Lee ◽  
Su Nam Lee ◽  
...  

Current treatments for acute myocardial infarction (AMI) have dramatically improved clinical outcomes during the first year after AMI. Less is known, however, about the subsequent risks of recurrent cardiovascular events and mortality in patients who survive 1 year after AMI. The purpose of the present study is to evaluate long-term clinical outcomes in 1-year AMI survivors who were implanted with newer-generation drug-eluting stents (DESs) since 2010. The COREA-AMI (CardiOvascular Risk and idEntificAtion of potential high-risk population in AMI) registry consecutively enrolled AMI patients who underwent percutaneous coronary intervention (PCI), and patients who received newer-generation DESs since 2010 were analyzed. The primary endpoint was major adverse cardiovascular events (MACEs), and secondary endpoint was all-cause mortality. Of 6242 AMI patients, 5397 were alive 1 year after the index procedure. The cumulative incidence of MACEs and all-cause death 1 to 7 years after AMI were 28.4% (annually 4–6%) and 20.2% (annually 3–4%), respectively. Multivariate analysis showed that uncontrolled systolic blood pressure (SBP) and serum low-density lipoprotein cholesterol (LDL-C) concentration, as well as traditional risk factors, were associated with MACEs and all-cause death. Recurrent non-fatal myocardial infarction, ischemic stroke, and bleeding events within 1 year were significantly associated with all-cause death. The risks of adverse cardiovascular events and death remain high in AMI patients more than 1 year after the index PCI with newer-generation DESs. Traditional risk factors, uncontrolled SBP and LDL-C, and non-fatal adverse events within 1 year after the index procedure strongly influence long-term clinical outcomes.


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