Xience stent single-center registry
Description
ABSTRACT Background: Safety and effectiveness of the everolimus-eluting stent (EES) have been previously demonstrated. Aims: To assess very long-term performance and outcomes of the EES in a real-world population. Methods: This single-center registry prospectively enrolled 6,893 patients (mean age 66±9.7 years, 81.4% men) undergoing elective coronary intervention with the EES over a decade. Clinical follow-up (FU) was performed at 1 year and then yearly. Results: Multiple risk factors were present in 34%. Stable angina was the main stenting indication (78.1%), followed by unstable angina (5.3%) and positive stress test (16.6%) for 1- (44%) or 2/3-VD (56%). Multiple stents (stent/patient ratio: 2.1±0.8) in >1vessel were implanted in 36.9% (mean stent length=43±31.3 mm). At 1 year, 80% of patients were on dual antiplatelet therapy, while 3% only at 2 years. A low (5%) 1-year MACE rate was observed; ST occurred in 19 (0.3%) patients with a prevalence of early (9) over late (4) and very late (6) (0.08%) events. Clinically driven TLR/TVR occurred in 3.3% at 1-year follow-up. Long-term FU (3 years) completed in 6210 (90%) patients showed a 5.9% MACE rate, while very long-term (>5 years and up to 10 years) follow-up, available in 3550 out of 4635 exposed patients (72%), showed an 8.6% MACE rate. Independent MACE predictors were stented segment length (OR: 2.1; 95% CI:1.57-2.82), small vessel stenting (OR: 1.34;95% CI: 1.08-1.68) and multivessel disease (2VD, OR:1.59; 95% CI: 1.21-2.08; 3VD, OR: 2.26; 95% CI: 1.72-2.97). Conclusions: This large prospective registry confirms the very long-term safety and efficacy of the EES in unselected real world and complex coronary lesions.