Impact of Routine Use of Drug-eluting Stents in Contemporary Interventional Cardiology at a Tertiary Center: One-decade Experience of the DESIRE Registry

background: Drug-eluting stents (DES) have changed contemporary interventional cardiology practice, enabling the approach of increasingly more complex clinical and angiographic scenarios. The objective of this study was to demonstrate the changes observed in the last 10 years in the indication and practice of percutaneous coronary intervention (PCI) at a tertiary private hospital in the State of São Paulo. Methods: DESIRE is a single-center prospective registry aiming at following the acute and late outcomes of consecutive patients treated by DES. Results: From 2002 to 2011, 4,299 patients were included, with mean age of 64.3 ± 11.2 years, 23% were female and 30.5 were diabetic. The total number of lesions treated was 6,518 of which 61.5% were type B2/C. During the course of the study, DES were progressively more used, reaching a penetration of 88.4% in 2011. The complexity of PCIs has increased and in the past year 1.76 lesions per patient were treated with an average of 1.89 DES. The SYNTAX score increased from 12.3 ± 4.4 (2002-2006) to 15.7 ± 4.7 (2007-2011). Clinical follow-up was obtained in 98.2% of the patients, with a median of 5.2 years, and during this period target-lesion revascularization rate was 5%, myocardial infarction was 6.7% and cardiovascular death was 4.1%. Stent thrombosis was observed in 2.4% of the cases. Conclusions: Our results showed a marked increment in the complexity profile of patients treated in the last 10 years and at the same time confirm the long-term 1 Doctor. Cardiologist Physician at Hospital do Coração da Associação do Sanatório Sírio. São Paulo, SP, Brazil. 2 Full Professor. Cardiologist Physician at Hospital do Coração da Associação do Sanatório Sírio. São Paulo, SP, Brasil. São Paulo, SP, Brazil. 3 Cardiologist Physician at Hospital do Coração da Associação do Sanatório Sírio. São Paulo, SP, Brazil. 4 Doctor. Cardiologist Physician at Hospital do Coração da Associação do Sanatório Sírio. São Paulo, SP, Brazil. 5 Cardiologist Physician at Hospital do Coração da Associação do Sanatório Sírio. São Paulo, SP, Brazil. 6 Cardiologist Physician at Hospital do Coração da Associação do Sanatório Sírio. São Paulo, SP, Brazil. 7 Engineer and programmer at Hospital do Coração da Associação do Sanatório Sírio. São Paulo, SP, Brazil. 8 Full professor. Head of Invasive Cardiology Service of do Hospital do Coração da Associação do Sanatório Sírio. São Paulo, SP, Brazil. Correspondence to: J. Eduardo Sousa. Rua Abílio Soares, 250 – 12o andar – Paraíso – São Paulo, SP, Brazil – CEP 04005-000 E-mail: [email protected] Received on: 10/8/2012 • Accepted on: 12/4/2012 Original Article