Comparison of zotarolimus- and everolimus-eluting stents in patients with ST-elevation myocardial infarction and chronic kidney disease undergoing primary percutaneous coronary intervention

Title
Comparison of zotarolimus- and everolimus-eluting stents in patients with ST-elevation myocardial infarction and chronic kidney disease undergoing primary percutaneous coronary intervention
Author(s)
김영조정명호[정명호]khurshid ahmed[khurshid ahmed]홍영준[홍영준]심두선[심두선]박근호[박근호]김주한[김주한]안영근[안영근]강정채[강정채]조명찬[조명찬]
Keywords
STAGE RENAL-DISEASE; BARE METAL STENTS; CLINICAL-TRIALS; IMPACT; REVASCULARIZATION; INSUFFICIENCY; OUTCOMES; MORTALITY; METAANALYSIS; DYSFUNCTION
Issue Date
201410
Publisher
ELSEVIER SCIENCE BV
Citation
JOURNAL OF CARDIOLOGY, v.64, no.3-4, pp.273 - 278
Abstract
Background: Chronic kidney disease (CKD) is associated with poor outcomes after percutaneous coronary intervention (PCI). The aim of the study was to compare zotarolimus- and everolimus-eluting stents used during primary PCI in patients with acute myocardial infarction (AMI) and CKD. Methods: We selected 854 consecutive ST-elevation MI patients with CKD (estimated glomerular filtration rate <60 mL/min/1.73 m(2)) undergoing primary PCI who were followed up for 12 months. They were divided into two groups based on type of stents implanted: (1) zotarolimus-eluting stent (ZES) and (2) everolimus-eluting stent (EES). The study end point was the 12-month major adverse cardiac events (MACE) which included all-cause death, non-fatal MI, target lesion revascularization (TLR), and target vessel revascularization (TVR). Results: The average number of stents used per vessel was 1.4 +/- 0.7. A total of 433 patients received ZES and 421 patients received EES. There was no significant difference in the incidence of 12-month MI, TLR, or TVR. All-cause death was found to be borderline significant between two groups (2.8% in ZES vs 0.9% in EES, p = 0.05). The incidence of 12-month MACE in ZES and EES was 5.7% and 2.6% respectively, p = 0.022. Stent thrombosis did not differ between groups (p = 0.677). Kaplan-Meier analysis did not show significant difference for 12-month MACE-free survival between groups (log-rank p = 0.158). It remained the same even after propensity adjustment for multiple confounders in Cox model (p = 0.326). Conclusions: Implantation of ZES or EES provided comparable clinical outcomes with similar risk of 12-month MACE and death in STEMI patients with CKD undergoing primary PCI. (C) 2014 Published by Elsevier Ltd on behalf of Japanese College of Cardiology.
URI
http://hdl.handle.net/YU.REPOSITORY/30627http://dx.doi.org/10.1016/j.jjcc.2014.02.002
ISSN
0914-5087
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의과대학 > 내과학교실 > Articles
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