Paclitaxel- Versus Sirolimus-Eluting Stents for Treatment of ST-Segment Elevation Myocardial Infarction With Analyses for Diabetic and Nondiabetic Subpopulation

Title
Paclitaxel- Versus Sirolimus-Eluting Stents for Treatment of ST-Segment Elevation Myocardial Infarction With Analyses for Diabetic and Nondiabetic Subpopulation
Author(s)
김영조조영진[조영진]양한모[양한모]박경우[박경우]정우영[정우영]최동주[최동주]서원우[서원우]정경태[정경태]채성철[채성철]이명용[이명용]허성호[허성호]채제근[채제근]성인환[성인환]윤정한[윤정한]오석규[오석규]김두일[김두일]박검수[박검수]라성운[라성운]장양수[장양수]배장호[배장호]홍택종[홍택종]조명찬[조명찬]정명호[정명호]김민정[김민정]Sue K Park[Sue K Park]채인호[채인호]김효수[김효수]
Keywords
BARE-METAL STENTS; PERCUTANEOUS CORONARY INTERVENTION; PROPENSITY SCORE; RANDOMIZED-TRIAL; UNCOATED STENTS; ARTERY-DISEASE; OUTCOMES; MUSCLE; MELLITUS; REVASCULARIZATION
Issue Date
201005
Publisher
ELSEVIER SCIENCE INC
Citation
JACC-CARDIOVASCULAR INTERVENTIONS, v.3, no.5, pp.498 - 506
Abstract
Objectives The aim of this study was to determine which drug-eluting stent (DES) is preferable for the treatment of ST-segment elevation myocardial infarction (STEMI) and to elucidate the impact of diabetes mellitus on the outcome of each DES. Background Recent studies have shown the benefit of DES in patients with STEMI. Diabetes mellitus might differentially affect outcomes of each DES. Methods We analyzed the large-scale, prospective, observational KAMIR (Korea Acute Myocardial Infarction Registry) study, which enrolled 4,416 STEMI patients (26% with diabetes) treated with paclitaxel-eluting stent (PES) or sirolimus-eluting stent (SES). Primary outcome was major adverse cardiac event (MACE), defined as a composite of mortality, nonfatal myocardial infarction, and target lesion revascularization (TLR). Results In the overall population, the MACE rate at 1 year was significantly higher in the PES than the SES group (11.6% vs. 8.6%, p = 0.014), which was mainly due to increased TLR (3.7% vs. 1.8%, p < 0.001). In the diabetic subgroup, however, the MACE rate was not significantly different between PES and SES (14.5% vs. 12.3%, p = 0.217), in contrast to the nondiabetic subgroup, where PES was inferior to SES as in the overall population. Matching by propensity-score did not significantly alter these results. For TLR, there was interaction between the type of stents and diabetes mellitus (unadjusted: p = 0.052; after propensity-score matching: p = 0.035). Conclusions The PES was inferior to the SES in the overall population, with regard to the occurrence of MACE and TLR. However, subgroup analysis for diabetic subjects showed no differences in clinical outcomes between PES and SES. These results suggest that diabetes differentially affects the outcome of first-generation DES. (J Am Coll Cardiol Intv 2010;3:498-506) (C) 2010 by the American College of Cardiology Foundation
URI
http://hdl.handle.net/YU.REPOSITORY/22442http://dx.doi.org/10.1016/j.jcin.2010.02.011
ISSN
1936-8798
Appears in Collections:
의과대학 > 내과학교실 > Articles
Files in This Item:
There are no files associated with this item.
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE