PLoS ONE (Jan 2020)

Polymer-free sirolimus-eluting stent use in Europe and Asia: Ethnic differences in demographics and clinical outcomes.

  • Florian Krackhardt,
  • Matthias Waliszewski,
  • Wan Azman Wan Ahmad,
  • Viktor Kočka,
  • Petr Toušek,
  • Bronislav Janek,
  • Milan Trenčan,
  • Peter Krajči,
  • Fernando Lozano,
  • Koldobika Garcia-San Roman,
  • Imanol Otaegui Irurueta,
  • Bruno Garcia Del Blanco,
  • Lucie Wachowiak,
  • Victoria Vilalta Del Olmo,
  • Eduard Fernandez Nofrerías,
  • Myung Ho Jeong,
  • Byung-Chun Jung,
  • Kyu-Rock Han,
  • Christophe Piot,
  • Laurent Sebagh,
  • Jérôme Rischner,
  • Michel Pansieri,
  • Matthias Leschke,
  • Tae Hoon Ahn

DOI
https://doi.org/10.1371/journal.pone.0226606
Journal volume & issue
Vol. 15, no. 1
p. e0226606

Abstract

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BackgroundThe objective of this study was to assess regional and ethnic differences in an unselected patient population treated with polymer-free sirolimus-eluting stents (PF-SES) in Asia and Europe.MethodsTwo all-comers observational studies based on the same protocol (ClinicalTrials.gov Identifiers: NCT02629575 and NCT02905214) were combined for data analysis to assure sufficient statistical power. The primary endpoint was the accumulated target lesion revascularization (TLR) rate at 9-12 months.ResultsOf the total population of 7243 patients, 44.0% (3186) were recruited in the Mediterranean region and 32.0% (2317) in central Europe. The most prominent Asian region was South Korea (17.6%, 1274) followed by Malaysia (5.7%, 413). Major cardiovascular risk factors varied significantly across regions. The overall rates for accumulated TLR and MACE were low with 2.2% (140/6374) and 4.4% (279/6374), respectively. In ACS patients, there were no differences in terms of MACE, TLR, MI and accumulated mortality between the investigated regions. Moreover, dual antiplatelet therapy (DAPT) regimens were substantially longer in Asian countries even in patients with stable coronary artery disease as compared to those in Europe.ConclusionsPF-SES angioplasty is associated with low clinical event rates in all regions. Further reductions in clinical event rates seem to be associated with longer DAPT regimens.