Long-term Outcomes of contemporary Percutaneous Coronary Intervention with the Xience Drug-Eluting Stent: Results from a Multicentre Australian Registry

BackgroundSeveral large registries have evaluated outcomes after percutaneous coronary intervention (PCI) in the USA, however there are no contemporary data regarding long-term outcomes after PCI in Australia, and little information comparing new second generation drug-eluting stents (DES) with earlier DES. Also, approval of new-generation drug-eluting stents (DES) is almost exclusively based on non-inferiority trials comparing outcomes with first generation DES, and there are limited data comparing safety and efficacy outcomes of new second generation DES with bare metal stents (BMS). This study long-term outcomes after PCI with the Xience DES from a large national multicentre registry, the GenesisCare Outcomes Registry (GCOR).MethodsThe study population comprised the first 1500 patients consecutively enrolled from January 2015 to January 2019 who were treated exclusively with either Xience DES or BMS and were eligible for 1-year follow-up, from a total group of 4,765 PCI patients enrolled during that period. Baseline patient and procedural data, medications and major adverse cardiovascular events (MACE) in-hospital, at 30-days and 1-year were reported and analysed with respect to the type of stent used (Xience DES n = 1000, BMS n = 500).ResultsOf the 4,765 patients enrolled in GCOR during this period, DES were exclusively used in 3621 (76.0%), BMS were exclusively used in 596 (12.5%) with the remainder receiving a combination of DES and BMS. In the study cohort of 1,500 Xience and BMS patients the mean age was 68.4 ± 10.7 years, 76.9% were male, 24.6% had diabetes mellitus and 45.9% presented with acute coronary syndromes. Adverse clinical event rates In the study cohort were low in comparison to international reports at 30-days in terms of mortality (0.20%), target lesion revascularisation (TLR, 0.27%) and MACE (0.47%). Similarly, adverse clinical event rates at 12 months were low in terms of mortality (1.26%), TLR (1.16%) and MACE (1.78%).ConclusionsClinical practice and long-term outcomes of PCI with the Xience DES in Australia are consistent with international series. Recent trends indicate DES use has increased in parallel with good outcomes despite an increasingly complex patient and lesion cohort.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000899943This trial was registered retrospectively on 11/09/2020.