Unrestricted Use of 2 New-Generation Drug-Eluting Stents in Patients With Acute Myocardial Infarction A Propensity Score-Matched Analysis

Title
Unrestricted Use of 2 New-Generation Drug-Eluting Stents in Patients With Acute Myocardial Infarction A Propensity Score-Matched Analysis
Author(s)
김영조Kang-Yin Chen[Kang-Yin Chen]라성운[라성운]Lin Wang[Lin Wang]Young-Ji Li[Young-Ji Li]Guang-Ping Li[Guang-Ping Li]Kanhaiya L.[Kanhaiya L.]박지영[박지영]최철웅[최철웅]박창규[박창규]서홍성[서홍성]오동주[오동주]정명호[정명호]안영근[안영근]홍택종[홍택종]허성호[허성호]서완인[서완인]채제건[채제건]조명찬[조명찬]배장호[배장호]최동훈[최동훈]장양수[장양수]채인호[채인호]김종진[김종진]윤장한[윤장한]정욱성[정욱성]승기배[승기배]박성정[박성정]
Keywords
CORONARY-ARTERY-DISEASE; DUAL ANTIPLATELET THERAPY; BIFURCATION LESIONS; CLINICAL-EVALUATION; TRIAL; EVEROLIMUS; THROMBOSIS; IMPACT; OUTCOMES; INTERVENTION
Issue Date
201209
Publisher
ELSEVIER SCIENCE INC
Citation
JACC-CARDIOVASCULAR INTERVENTIONS, v.5, no.9, pp.936 - 945
Abstract
Objectives This study sought to compare everolimus-eluting stents (EES) with zotarolimus-eluting stents (ZES) in patients with acute myocardial infarction (AMI). Background There is a paucity of data to exclusively evaluate the safety and efficacy of second-generation drug-eluting stents (DES) in the setting of AMI. Methods The present study enrolled 3,309 AMI patients treated with ZES (n = 1,608) or EES (n = 1,701) in a large-scale, prospective, multicenter registry-KAMIR (Korea Acute Myocardial Infarction Registry). Propensity score matching was applied to adjust for differences in baseline clinical and angiographic characteristics, producing a total of 2,646 patients (1,343 receiving ZES, and 1,343 receiving EES). Target lesion failure (TLF) was defined as the composite of cardiac death, recurrent nonfatal myocardial infarction, or target lesion revascularization. Major clinical outcomes at 1 year were compared between the 2 propensity score-matched groups. Results After propensity score matching, baseline clinical and angiographic characteristics were similar between the 2 groups. Clinical outcomes of the propensity score-matched patients showed that, despite similar incidences of recurrent nonfatal myocardial infarction and in-hospital and 1-year mortality, patients in the EES group had significantly lower rates of TLF (6.5% vs. 8.7%, p = 0.029) and probable or definite stent thrombosis (0.3% vs. 1.6%, p < 0.001), compared with those in the ZES group. Furthermore, there was a numerically lower rate of target lesion revascularization (1.2% vs. 2.2%, p = 0.051) in the EES group than in the ZES group. Conclusions In this propensity-matched comparison, EES seems to be superior to ZES in reducing TLF and stent thrombosis in patients with AMI. (J Am Coll Cardiol Intv 2012;5:936-45) (C) 2012 by the American College of Cardiology Foundation
URI
http://hdl.handle.net/YU.REPOSITORY/27320http://dx.doi.org/10.1016/j.jcin.2012.05.009
ISSN
1936-8798
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