Comparisons of everolimus and paclitaxel-eluting stents in patients with acute myocardial infarction

Kang Yin Chen, Seung-Woon Rha, Yong Jian Li, Guang Ping Li, Dong Joo Oh, Myung Ho Jeong, Young Jo Kim, Seung Ho Hur, Jang Ho Bae, Tae Hoon Ahn

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Abstract

Background It has been established that the newer-generation drug-eluting stent (DES) everolimus-eluting stent (EES) is superior to the first-generation DES paclitaxel-eluting stent (PES). However, the advantages of EES over PES in the setting of acute myocardial infarction (AMI) need to be fully elucidated. Methods The present analysis enrolled 2,911 AMI patients receiving PES (n = 1,210) or EES (n = 1,701) in a large-scale, prospective, multicenter Korea Acute Myocardial Infarction Registry (KAMIR). Propensity score matching was used to adjust for baseline biases in clinical and angiographic characteristics, yielding a total of 2,398 patients (1,199 receiving PES and 1,199 receiving EES). Various clinical outcomes at 1 year were compared between the two propensity score matched groups. Target lesion failure (TLF) was defined as the composite of cardiac death, recurrent nonfatal myocardial infarction (Re-MI), or target lesion revascularization (TLR). Results Baseline clinical and angiographic characteristics were comparable between the two groups after propensity score matching. Clinical outcomes of the propensity score matched patients showed that the rates of in-hospital and 1-year cardiac and all-cause death were similar between the two groups. But patients in the EES group had significantly lower incidences of Re-MI (1.4% vs 2.8%, P = 0.002), TLR (1.2% vs 3.1%, P = 0.001), TLF (6.4% vs 10.2%, P = 0.001), and probable or definite stent thrombosis (0.3% vs 1.8%, P < 0.001) than did those in the PES group. Conclusions The present propensity matched analysis suggests that the use of EES in the setting of AMI appears to be superior to PES in reducing TLF, and stent thrombosis.

Original languageEnglish
Pages (from-to)147-156
Number of pages10
JournalJournal of Interventional Cardiology
Volume28
Issue number2
DOIs
Publication statusPublished - 2015 Apr 1

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Paclitaxel
Stents
Myocardial Infarction
Propensity Score
Drug-Eluting Stents
Everolimus
Thrombosis
Korea
Registries
Cause of Death
Research Design

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Comparisons of everolimus and paclitaxel-eluting stents in patients with acute myocardial infarction. / Chen, Kang Yin; Rha, Seung-Woon; Li, Yong Jian; Li, Guang Ping; Oh, Dong Joo; Jeong, Myung Ho; Kim, Young Jo; Hur, Seung Ho; Bae, Jang Ho; Ahn, Tae Hoon.

In: Journal of Interventional Cardiology, Vol. 28, No. 2, 01.04.2015, p. 147-156.

Research output: Contribution to journalArticle

Chen, KY, Rha, S-W, Li, YJ, Li, GP, Oh, DJ, Jeong, MH, Kim, YJ, Hur, SH, Bae, JH & Ahn, TH 2015, 'Comparisons of everolimus and paclitaxel-eluting stents in patients with acute myocardial infarction', Journal of Interventional Cardiology, vol. 28, no. 2, pp. 147-156. https://doi.org/10.1111/joic.12187
Chen, Kang Yin ; Rha, Seung-Woon ; Li, Yong Jian ; Li, Guang Ping ; Oh, Dong Joo ; Jeong, Myung Ho ; Kim, Young Jo ; Hur, Seung Ho ; Bae, Jang Ho ; Ahn, Tae Hoon. / Comparisons of everolimus and paclitaxel-eluting stents in patients with acute myocardial infarction. In: Journal of Interventional Cardiology. 2015 ; Vol. 28, No. 2. pp. 147-156.
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abstract = "Background It has been established that the newer-generation drug-eluting stent (DES) everolimus-eluting stent (EES) is superior to the first-generation DES paclitaxel-eluting stent (PES). However, the advantages of EES over PES in the setting of acute myocardial infarction (AMI) need to be fully elucidated. Methods The present analysis enrolled 2,911 AMI patients receiving PES (n = 1,210) or EES (n = 1,701) in a large-scale, prospective, multicenter Korea Acute Myocardial Infarction Registry (KAMIR). Propensity score matching was used to adjust for baseline biases in clinical and angiographic characteristics, yielding a total of 2,398 patients (1,199 receiving PES and 1,199 receiving EES). Various clinical outcomes at 1 year were compared between the two propensity score matched groups. Target lesion failure (TLF) was defined as the composite of cardiac death, recurrent nonfatal myocardial infarction (Re-MI), or target lesion revascularization (TLR). Results Baseline clinical and angiographic characteristics were comparable between the two groups after propensity score matching. Clinical outcomes of the propensity score matched patients showed that the rates of in-hospital and 1-year cardiac and all-cause death were similar between the two groups. But patients in the EES group had significantly lower incidences of Re-MI (1.4{\%} vs 2.8{\%}, P = 0.002), TLR (1.2{\%} vs 3.1{\%}, P = 0.001), TLF (6.4{\%} vs 10.2{\%}, P = 0.001), and probable or definite stent thrombosis (0.3{\%} vs 1.8{\%}, P < 0.001) than did those in the PES group. Conclusions The present propensity matched analysis suggests that the use of EES in the setting of AMI appears to be superior to PES in reducing TLF, and stent thrombosis.",
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T1 - Comparisons of everolimus and paclitaxel-eluting stents in patients with acute myocardial infarction

AU - Chen, Kang Yin

AU - Rha, Seung-Woon

AU - Li, Yong Jian

AU - Li, Guang Ping

AU - Oh, Dong Joo

AU - Jeong, Myung Ho

AU - Kim, Young Jo

AU - Hur, Seung Ho

AU - Bae, Jang Ho

AU - Ahn, Tae Hoon

PY - 2015/4/1

Y1 - 2015/4/1

N2 - Background It has been established that the newer-generation drug-eluting stent (DES) everolimus-eluting stent (EES) is superior to the first-generation DES paclitaxel-eluting stent (PES). However, the advantages of EES over PES in the setting of acute myocardial infarction (AMI) need to be fully elucidated. Methods The present analysis enrolled 2,911 AMI patients receiving PES (n = 1,210) or EES (n = 1,701) in a large-scale, prospective, multicenter Korea Acute Myocardial Infarction Registry (KAMIR). Propensity score matching was used to adjust for baseline biases in clinical and angiographic characteristics, yielding a total of 2,398 patients (1,199 receiving PES and 1,199 receiving EES). Various clinical outcomes at 1 year were compared between the two propensity score matched groups. Target lesion failure (TLF) was defined as the composite of cardiac death, recurrent nonfatal myocardial infarction (Re-MI), or target lesion revascularization (TLR). Results Baseline clinical and angiographic characteristics were comparable between the two groups after propensity score matching. Clinical outcomes of the propensity score matched patients showed that the rates of in-hospital and 1-year cardiac and all-cause death were similar between the two groups. But patients in the EES group had significantly lower incidences of Re-MI (1.4% vs 2.8%, P = 0.002), TLR (1.2% vs 3.1%, P = 0.001), TLF (6.4% vs 10.2%, P = 0.001), and probable or definite stent thrombosis (0.3% vs 1.8%, P < 0.001) than did those in the PES group. Conclusions The present propensity matched analysis suggests that the use of EES in the setting of AMI appears to be superior to PES in reducing TLF, and stent thrombosis.

AB - Background It has been established that the newer-generation drug-eluting stent (DES) everolimus-eluting stent (EES) is superior to the first-generation DES paclitaxel-eluting stent (PES). However, the advantages of EES over PES in the setting of acute myocardial infarction (AMI) need to be fully elucidated. Methods The present analysis enrolled 2,911 AMI patients receiving PES (n = 1,210) or EES (n = 1,701) in a large-scale, prospective, multicenter Korea Acute Myocardial Infarction Registry (KAMIR). Propensity score matching was used to adjust for baseline biases in clinical and angiographic characteristics, yielding a total of 2,398 patients (1,199 receiving PES and 1,199 receiving EES). Various clinical outcomes at 1 year were compared between the two propensity score matched groups. Target lesion failure (TLF) was defined as the composite of cardiac death, recurrent nonfatal myocardial infarction (Re-MI), or target lesion revascularization (TLR). Results Baseline clinical and angiographic characteristics were comparable between the two groups after propensity score matching. Clinical outcomes of the propensity score matched patients showed that the rates of in-hospital and 1-year cardiac and all-cause death were similar between the two groups. But patients in the EES group had significantly lower incidences of Re-MI (1.4% vs 2.8%, P = 0.002), TLR (1.2% vs 3.1%, P = 0.001), TLF (6.4% vs 10.2%, P = 0.001), and probable or definite stent thrombosis (0.3% vs 1.8%, P < 0.001) than did those in the PES group. Conclusions The present propensity matched analysis suggests that the use of EES in the setting of AMI appears to be superior to PES in reducing TLF, and stent thrombosis.

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