Raimund Erbel1, Holger Eggebrecht2, Ariel Roguin3, Erwin Schroeder4, Sebastian Philipp5, Thomas Heitzer6, Harald Schwacke7, Oded Ayzenberg8, Antonio Serra9, Nicolas Delarche10, Andreas Luchner11, Ton Slagboom12. 1. Department of Cardiology, University of Duisburg-Essen, Essen, Germany. Electronic address: erbel@uk-essen.de. 2. Cardioangiological Center Bethanien (CCB), Frankfurt, Germany. 3. Department of Cardiology, Rambam Medical Center, Haifa, Israel. 4. Division of Cardiovascular Medicine, Cliniques Universitaires de Mont-Godinne, Yvoir, Belgium. 5. Department Internal Medicine/Cardiology, Elbe Klinikum Stade, Stade, Germany. 6. Department of Cardiology, Heart Center Dortmund, Dortmund, Germany. 7. Department of Internal Medicine, Diakonissen-Stiftungs- Krankenhaus Speyer, Germany. 8. The Heart Institute, Kaplan Medical Center, Rehovot, Israel. 9. Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, España. 10. Cardiology unit, Pau General Hospital, Pau, France. 11. Department of Internal Medicine/Cardiology, Universitätsklinikum Regensburg, Germany. 12. Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
Abstract
BACKGROUND: Novel bare metal stents with improved stent design may become a viable alternative to drug-eluting stents in certain patient groups, particularly, when long-term dual antiplatelet therapy should be avoided. PURPOSE: The ENERGY registry aimed to assess the safety and benefits of a cobalt-chromium thin strut bare metal stent with a passive coating in a large series of patients under real-world conditions. METHODS AND MATERIALS: This prospective registry recruited 1016 patients with 1074 lesions in 48 centers from April to November 2010. The primary endpoint was the rate of major adverse cardiac events (MACEs), a composite of cardiac death, myocardial infarction and clinically driven target lesion revascularization. RESULTS: More than half of the lesions (61.0%) were type A/B1 lesions, mean lesion length was 14.5±6.5mm and mean reference vessel diameter 3.2±0.5mm. MACE rates at 6, 12 and 24months were 4.9%, 8.1% and 9.4%, target lesion revascularization rates 2.8%, 4.9% and 5.4% and definite stent thrombosis rates 0.5%, 0.6% and 0.6%. Subgroups showed significant differences in baseline and procedural characteristics which did not translate into significantly different clinical outcomes. Specifically, MACE rates at 24months were 13.5% in diabetics, 8.6% in small stents and 9.6% in acute coronary syndrome patients. CONCLUSION: The population of ENERGY reflects real-world conditions with bare metal stents being mainly used in simple lesions. In this setting, percutaneous coronary intervention using a cobalt-chromium thin strut bare metal stent with a passive coating showed very good results up to 24months. (ClinicalTrials.gov:NCT01056120) SUMMARY FOR ANNOTATED TABLE OF CONTENTS: The ENERGY international registry evaluated the safety and benefits of a cobalt-chromium thin strut bare metal stent with passive coating in 1016 patients under real-world conditions until 2years. Results were encouraging with a low composite rate of cardiac death, myocardial infarction and clinically driven target lesion revascularization, even in the pre-defined high risk groups of diabetes, stents ≤2.75mm and acute coronary syndrome.
BACKGROUND: Novel bare metal stents with improved stent design may become a viable alternative to drug-eluting stents in certain patient groups, particularly, when long-term dual antiplatelet therapy should be avoided. PURPOSE: The ENERGY registry aimed to assess the safety and benefits of a cobalt-chromium thin strut bare metal stent with a passive coating in a large series of patients under real-world conditions. METHODS AND MATERIALS: This prospective registry recruited 1016 patients with 1074 lesions in 48 centers from April to November 2010. The primary endpoint was the rate of major adverse cardiac events (MACEs), a composite of cardiac death, myocardial infarction and clinically driven target lesion revascularization. RESULTS: More than half of the lesions (61.0%) were type A/B1 lesions, mean lesion length was 14.5±6.5mm and mean reference vessel diameter 3.2±0.5mm. MACE rates at 6, 12 and 24months were 4.9%, 8.1% and 9.4%, target lesion revascularization rates 2.8%, 4.9% and 5.4% and definite stent thrombosis rates 0.5%, 0.6% and 0.6%. Subgroups showed significant differences in baseline and procedural characteristics which did not translate into significantly different clinical outcomes. Specifically, MACE rates at 24months were 13.5% in diabetics, 8.6% in small stents and 9.6% in acute coronary syndromepatients. CONCLUSION: The population of ENERGY reflects real-world conditions with bare metal stents being mainly used in simple lesions. In this setting, percutaneous coronary intervention using a cobalt-chromium thin strut bare metal stent with a passive coating showed very good results up to 24months. (ClinicalTrials.gov:NCT01056120) SUMMARY FOR ANNOTATED TABLE OF CONTENTS: The ENERGY international registry evaluated the safety and benefits of a cobalt-chromium thin strut bare metal stent with passive coating in 1016 patients under real-world conditions until 2years. Results were encouraging with a low composite rate of cardiac death, myocardial infarction and clinically driven target lesion revascularization, even in the pre-defined high risk groups of diabetes, stents ≤2.75mm and acute coronary syndrome.