Study population

These presentations include all stents used in Sweden from 2007 until the end of enrolment which is shown at the different figures. Stents implanted until the end of 2007 at one small center (Skövde Hospital) were excluded, as this hospital was not recording their subsequent coronary angiographies in SCAAR during this period. Also stents with missing data (less than 1%) were excluded.

The SCAAR registry (SWEDHEART registry)

SCAAR/SWEDHEART records consecutive patients from all centres (n=29) performing coronary angiography and PCI in Sweden. The treating physician reports each procedure on-line via a web-interface directly from the catheterization laboratory. In early 2004 an interactive method for registration of restenosis was implemented in SCAAR. During the registration of a coronary angiography or PCI a mandatory question regarding the existence of any type of restenosis has to be answered. A detailed interactive presentation of all previously (in Sweden) treated coronary segments of the patient is displayed. Information about date, hospital and coronary segment together with name and dimension of stents used are shown. The treating physician must record any restenosis and, from April 2005, also information about acute occlusions in the specified stents. From 2007 also non-occlusive angiographical stent thrombosis is reported in SCAAR.

Definitions

An stent thrombosis is defined in SCAAR as an angiographic occlusion or a non-occlusive angiographical thrombus (assessed by the angiographer) in a previously implanted stent with an acute clinical presentation.

A restenosis is defined as a new occurring obstruction with at least 50% diameter angiographical obstruction and/or as judged by another invasive method (as FFR, IFR, IVUS or OCT) in a previously implanted stent. In old presentations before 2018 any at least 50% obstruction was presented as restenosis (also stentrombosis). In newer presentations (2018-) lesions classified as stent thrombosis is only presented as stent thrombosis and not as restenosis.

A bifurcation lesion is recorded if there is a stenosis in a bifurcation with a side branch of at least 2 mm in diameter or if the treating physician regards the use of several guide-wires as desirable. Diameter of the stent is defined as the nominal diameter of the stent balloon or the nominal diameter of any larger balloon if the stent was postdilated. Chronic total occlusions are defined as occlusions with a probable duration of at least 3 months.

Stents implanted at more than 1000 occasions in Sweden during the study period are separately analyzed and presented. However if specified also stents used less often may be presented.

The names of the different stents are presented as they are entered in the database. Some similar stents are analysed together. The Multi-Link Vision® and the Multi-Link MiniVision® (Abbot Laboratories, USA) are both referred to as “Abbott multilink Vision”; Medtronic Driver® coronary stent and Medtronic Micro-Driver® coronary stent (Medrtonic Inc, USA) as “Medtronic Driver”; Cordis Cypher® and Cypher Select® (Cordis Corporation, USA) as“Cordis Cypher”; The Abbott XienceV and the Boston Scentific Promus stent are reported as “Xience V Promus”.

Statistical analyses

Cumulative event rates are estimated by the Kaplan-Meier method. The primary endpoint is the registration of stent thrombosis or restenosis in SCAAR.

All calculations are performed with a focus on individual stents. Thus the data are presented from the stent perspective with patient and procedure data linked to the individual stents.

In the analysis August 17th 2009 0,8 % of the stents were excluded from the analysis due to missing data. However, this group had a very similar rate of acute stent occlusions compared to those with complete data; RR (95% Confidence Interval), 0.998 (0.536-1.860).

The present study is exclusively descriptive and should only be regarded as hypothesis generating.

Copyright: ©SCAAR/SWEDHEART owns the rights of the presentations, but the pictures can freely be used with the reference of origin.

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