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Unrestricted use of 2 new-generation drug-eluting stents in patients with acute myocardial infarction: a propensity score-matched analysis

 Kang-Yin Chen  ;  Seung-Woon Rha  ;  Lin Wang  ;  Yong-Jian Li  ;  Guang-Ping Li  ;  Kanhaiya L. Poddar  ;  Ji-Young Park  ;  Cheol Ung Choi  ;  Chang-Gyu Park  ;  Hong Seog Seo  ;  Dong Joo Oh  ;  Myung Ho Jeong  ;  Young Keun Ahn  ;  Taek Jong Hong  ;  Young Jo Kim  ;  Seung Ho Hur  ;  In Whan Seong  ;  Jei Keon Chae  ;  Myeong Chan Cho  ;  Jang Ho Bae  ;  Dong Hoon Choi  ;  Yang Soo Jang  ;  In Ho Chae  ;  Chong Jin Kim  ;  Jung Han Yoon 
Journal Title
Issue Date
Aged ; Angioplasty, Balloon, Coronary/adverse effects ; Angioplasty, Balloon, Coronary/instrumentation* ; Angioplasty, Balloon, Coronary/mortality ; Cardiovascular Agents/administration & dosage* ; Chi-Square Distribution ; Coronary Angiography ; Coronary Thrombosis/etiology ; Coronary Thrombosis/prevention & control ; Drug-Eluting Stents* ; Everolimus ; Female ; Hospital Mortality ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Middle Aged ; Myocardial Infarction/diagnostic imaging ; Myocardial Infarction/mortality ; Myocardial Infarction/therapy* ; Platelet Aggregation Inhibitors/therapeutic use ; Propensity Score ; Proportional Hazards Models ; Prospective Studies ; Prosthesis Design ; Recurrence ; Registries ; Republic of Korea ; Risk Assessment ; Risk Factors ; Sirolimus/administration & dosage ; Sirolimus/analogs & derivatives* ; Time Factors ; Treatment Outcome
acute myocardial infarction ; everolimus-eluting stents ; percutaneous coronary intervention ; zotarolimus-eluting stents
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.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
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