First- Versus Second-Generation Drug-Eluting Stents in Acute Coronary Syndromes (Katowice-Zabrze Registry)

Abstract Background: There are sparse data on the performance of different types of drug-eluting stents (DES) in acute and real-life setting. Objective: The aim of the study was to compare the safety and efficacy of first- versus second-generation DES in patients with acute coronary syndromes (ACS). Methods: This all-comer registry enrolled consecutive patients diagnosed with ACS and treated with percutaneous coronary intervention with the implantation of first- or second-generation DES in one-year follow-up. The primary efficacy endpoint was defined as major adverse cardiac and cerebrovascular event (MACCE), a composite of all-cause death, nonfatal myocardial infarction, target-vessel revascularization and stroke. The primary safety outcome was definite stent thrombosis (ST) at one year. Results: From the total of 1916 patients enrolled into the registry, 1328 patients were diagnosed with ACS. Of them, 426 were treated with first- and 902 with second-generation DES. There was no significant difference in the incidence of MACCE between two types of DES at one year. The rate of acute and subacute ST was higher in first- vs. second-generation DES (1.6% vs. 0.1%, p < 0.001, and 1.2% vs. 0.2%, p = 0.025, respectively), but there was no difference regarding late ST (0.7% vs. 0.2%, respectively, p = 0.18) and gastrointestinal bleeding (2.1% vs. 1.1%, p = 0.21). In Cox regression, first-generation DES was an independent predictor for cumulative ST (HR 3.29 [1.30-8.31], p = 0.01). Conclusions: In an all-comer registry of ACS, the one-year rate of MACCE was comparable in groups treated with first- and second-generation DES. The use of first-generation DES was associated with higher rates of acute and subacute ST and was an independent predictor of cumulative ST.

Produção de latex por clones de seringueira (Hevea spp) no planalto e litoral do Estado de São Paulo

A partir dos dados de produção em volume de látex, extraído de clones de seringueira (Hevea spp.), durante 17 anos no Centro Experimental Theodureto de Camargo (Campinas, região de planalto) e 16 anos na Estação Experimental Vale do Ribeira (Pariquera-Açú, região litorânea), ambos pertencentes ao Instituto Agro_ nômico do Estado de São Paulo, Campinas, foi estudado o comportamento da produção de cada clone. Pelo teste de Tukey foi possível determinar, considerando-se as duas regiões, os melhores clones quanto ao potencial produtivo dado pelas médias de produção. Entre os melhores encontram-se: RRIM 600 e BSA 20. 0 primeiro pertence a Estação Experimental e o segundo ao Centro Experimental. Em seguida tem-se um grupo intermediário, formado pelos clones CA 1328, Tjir 16, C 228, RRIm 526, C 297, LCB 510 e Fx 25, todos pertencentes ao Centro Experimental. Os menos produtivos foram: Fx 25, C 290 e RRIM 600, todos pertencentes ao Centro Experimental. 0 clone Fx 25 apresentou baixa produção nas regiões estudadas, porém sua produção na Estação Experimental foi superior à do Centro Experimental, bem como às dos clones C 290 e RRIM 600, cultivados no Centro Experimental.