JACC. Cardiovascular interventions · 2012
Unrestricted use of 2 new-generation drug-eluting stents in patients with acute myocardial infarction: a propensity score-matched analysis.
Сравнительное исследованиеСтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Chen Kang-Yin, Rha Seung-Woon, Wang Lin, Li Yong-Jian, Li Guang-Ping, Poddar Kanhaiya L, Park Ji-Young, Choi Cheol Ung, Park Chang-Gyu, Seo Hong Seog, Oh Dong Joo, Jeong Myung Ho, Ahn Young Keun, Hong Taek Jong, Kim Young Jo, Hur Seung Ho, Seong In Whan, Chae Jei Keon, Cho Myeong Chan, Bae Jang Ho, Choi Dong Hoon, Jang Yang Soo, Chae In Ho, Kim Chong Jin, Yoon Jung Han, Chung Wook Sung, Seung Ki Bae, Park Seung Jung, KAMIR Investigators
Аннотация
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.
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.
Предметные рубрики MeSH
AgedAngioplasty, Balloon, CoronaryCardiovascular AgentsChi-Square DistributionCoronary AngiographyCoronary ThrombosisDrug-Eluting StentsEverolimusFemaleHospital MortalityHumansKaplan-Meier EstimateLogistic ModelsMaleMiddle AgedMyocardial InfarctionPlatelet Aggregation InhibitorsPropensity ScoreProportional Hazards ModelsProspective StudiesProsthesis DesignRecurrenceRegistriesRepublic of KoreaRisk AssessmentRisk FactorsSirolimusTime FactorsTreatment Outcome