Alex versus Xience Registry Preliminary report

Transcription

1 Interventional Cardiology Network Alex versus Xience Preliminary report Mariusz Gąsior 1,2, Marek Gierlotka 1, Lech Poloński 1,2 1 3rd Department of Cardiology, Medical University of Silesia Centre tor Research, Training and New Medical Technologies Silesian Centre for Heart Diseases, Zabrze, Poland 2 Polish Medical Group, Scanmed

2 Interventional Cardiology Network March 2010 January Hospitalizations Patients Coronary angiography PCI procedures

3 Interventional Cardiology Network Hospitalizations with coronary angiography Hospitalizations with PCI Number of used balloons Number of used stents BMS DES 18444

4 Alex versus Xience Stents summary - Alex / Xience Alex number of implanted stents 6951 Xience number of implanted stents 7790 Hospitalizations Alex + Xience only 422 Alex only 4251 Xience only 4697 Alex + other stent(s) 336 Xience + other stent(s) 526

5 Alex versus Xience 6951 Alex stents 7790 Xience stents 4251 hospitalizations Alex only 3559 first in registry hospitalizations Alex only 4697 hospitalizations Xience only 3970 first in registry hospitalizations Xience only 1135 first in registry hospitalizations Alex only Currently available 1-year FU for 1822 first in registry hospitalizations Xience only

6 Alex versus Xience 1135 first in registry hospitalizations Alex only 1822 first in registry hospitalizations Xience only STEMI 14,9% Stable angina 23,1% STEMI 10,5% Stable angina 25,4% NSTEMI 29,8% UA 32,2% NSTEMI 28,9% UA 35,2%

7 Alex versus Xience Clinical characteristics ALEX XIENCE P value Age < Women 37.3% 34.5% Hypertension 75.3% 75.7% 0.67 Diabetes mellitus 31.8% 31.3% 0.64 Obesity 26.8% 29.8% Prior myocardial infarction 26.1% 29.5% Prior PCI 16.1% 21.7% < Prior CABG 7.5% 7.7% < History of heart failure 20.6% 19.6% 0.29 Mitral valve disease 13.5% 13.4% 0.83 Aortic valve disease 3.5% 4.5% Atrial fibrillation 12.6% 10.2% History of stroke 4.6% 3.2% Chronic renal failure 6.3% 8.0% Chronic pulmonary diseases 3.3% 3.3% 0.98 Cardiogenic shock 1.9% 1.9% 0.97 Pulmonary edema 1.1% 1.0% 0.55 Left ventricle ejection fraction LVEF

8 Alex versus Xience Angiographic characteristics ALEX XIENCE P value LM >=50% 3.6% 5.4% < LAD >=70% 49.8% 60.5% < D12 >=70% 18.2% 20.5% IM >=70% 5.4% 4.9% 0.29 Cx >=70% 34.4% 33.8% 0.59 OM >=70% 22.0% 21.3% 0.47 RCA >= 70% 56.8% 50.2% < Number of stenosed arteries (0-4) >= 50% 1.9 ± ± Number of stenosed arteries (0-4) >= 70% 1.7 ± ± Multivessel disease (>=50%) 62.6% 63.3% 0.50 Multivessel disease (>=70%) 50.3% 50.9% 0.63 Restenosis 15.5% 18.4% <0.0001

9 Alex versus Xience PCI procedure characteristics ALEX XIENCE P value Treated arteries - LM 1.5% 4.4% < LAD 34.3% 49.6% < D 4.2% 6.5% < IM 2.0% 1.8% Cx 20.2% 19.2% OM 11.4% 9.5% RCA 37.8% 28.1% < Bypass 2.8% 2.2% 0.12 Number of treated arteries 1.2 ± ±

10 Alex versus Xience PCI procedure characteristics ALEX XIENCE P value Balloons number 1.5± ±1.1 < Balloons minimal diameter 2.3± ± Balloons maximal diameter 2.6± ±0.7 < Balloons total length 22.5± ±17.3 < Balloons max pressure 14.1± ± Stents number 1.4± ± Stents minimal diameter 2.8± ± Stents maximal diameter 3±0.6 3± Stents total length 26.5± ±18.1 < Stents max pressure 14.2± ± Direct stent implantation 42.3% 36.2% <0.0001

11 Alex versus Xience 12-month mortality

12 Alex versus Xience 12-month mortality 5% In-hospital mortality 4% 3% 2% 1% 2.3% 1.5% 0%

13 12-month mortality Multivariate analysis

14 12-month mortality AFTER DISCHARGE

15 12-month mortality after discharge Multivariate analysis

16 Death or myocardial infarction during 12 months after discharge

17 Death or myocardial infarction during 12 months after discharge Multivariate analysis

18 Death, myocardial infarction or PCI/CABG for any reason during 12 month after discharge

19 Death, myocardial infarction or PCI/CABG for any reason during 12 month after discharge Multivariate analysis

20 Alex versus Xience Events after discharge ALEX XIENCE P value Rehospitalizations: Ischemic heart disease (I20-I25) 33.5% 35.8% 0.22 Myocardial infarction 5.2% 6.1% 0.30 Heart failure 8.9% 8.1% 0.44 Valve diseases 1.7% 1.2% 0.29 Arrhythmias (except FA) 2.1% 2.2% 0.84 Atrial fibrillation 0.9% 1.6% 0.10 Procedures: Coronary angiography 27.1% 31.4% in stable angina 17.1% 19.0% in unstable angina 7.6% 7.9% in myocardial infarction 4.6% 5.7% in heart failure 0.2% 0.4% in other reasons 0.7% 1.4% 0.12 PCI 21.7% 21.2% in stable angina 14.5% 12.8% in unstable angina 5.1% 5.0% in myocardial infarction 3.8% 4.6% 0.30 CABG 2.1% 2.0% 0.92

21 12-month mortality

22 12-month mortality AFTER DISCHARGE

23 Death or myocardial infarction during 12 months after discharge

24 Death, myocardial infarction or PCI/CABG for any reason during 12 month after discharge