Coronary stents in patients with ST-elevation myocardial infarction and chronic kidney disease undergoing primary percutaneous coronary intervention

Khurshid Ahmed, Myung Ho Jeong, Rabin Chakraborty, Sumera Ahmed, Young Joon Hong, Doo Sun Sim, Keun Ho Park, Ju Han Kim, Youngkeun Ahn, Jung Chaee Kang, Myeong Chan Cho, Chong Jin Kim, Young Jo Kim, Shung Chull Chae, Jong Hyun Kim, Seung Ho Hur, In Whan Seong, Dong Hoon Choi, Jei Keon Chae, Taek Jong HongJae Young Rhew, Doo Il Kim, In Ho Chae, Jung Han Yoon, Bon Kwon Koo, Byung Ok Kim, Myoung Yong Lee, Kee Sik Kim, Jin Young Hwang, Seok Kyu Oh, Nae Hee Lee, Kyoung Tae Jeong, Seung Jea Tahk, Jang Ho Bae, Seung Woon Rha, Keum Soo Park, Kyoo Rok Han, Tae Hoon Ahn, Moo Hyun Kim, Ki Bae Seung, Wook Sung Chung, Ju Young Yang, Chong Yun Rhim, Hyeon Cheol Gwon, Seong Wook Park, Young Youp Koh, Seung Jae Joo, Soo Joong Kim, Dong Kyu Jin, Jin Man Cho, Sang Wook Kim, Jeong Kyung Kim, Tae Ik Kim, Deug Young Nah, Si Hoon Park, Sang Hyun Lee, Seung Uk Lee, Hang Jae Chung, Jang Hyun Cho, Seung Won Jin, Yang Soo Jang, Jeong Gwan Cho, Seung Jung Park

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background and Objectives: Chronic kidney disease (CKD) is associated with poor outcomes after percutaneous coronary intervention (PCI). We sought to compare different coronary stents used during primary PCI in patients with ST-elevation myocardial infarction (STEMI) and CKD. Subjects and Methods: We selected 2408 consecutive STEMI patients with CKD (estimated glomerular filtration rate <60 mL/min/1.73 m2) undergoing primary PCI and divided them into 5 groups based on the type of stent implanted: 1) bare metal stent (BMS), 2) paclitaxel-eluting stent (PES), 3) sirolimus-eluting stent (SES), 4) zotarolimus-eluting stent (ZES), or 5) everolimus-eluting stent (EES). The study end-point was the number of major adverse cardiac events (MACE) at 12 months. Results: There was no significant difference in the incidence of 12-month myocardial infarction, target lesion revascularization, or target vessel revascularization between stent groups; however, the overall rate of repeat revascularization differed significantly between groups. All-cause death differed significantly among the groups. The incidence of 12-month MACE in BMS, PES, SES, ZES, and EES was 8.3%, 9.8%, 8.6%, 5.5%, and 2.6%, respectively (p<0.001). Kaplan-Meier analysis did not show a significant differences in 12-month MACE-free survival among the groups (log-rank p=0.076). This finding remained the same after adjusting for multiple confounders (p=0.147). Conclusion: Any of the 5 stents can be used to treat STEMI patients with CKD undergoing primary PCI; all have similar risk of 12-month MACE. This result is hypothesis-generating and warrants further evaluation with a long-term randomized study.

Original languageEnglish
Pages (from-to)830-838
Number of pages9
JournalKorean Circulation Journal
Volume42
Issue number12
DOIs
Publication statusPublished - 2012 Dec

Keywords

  • Angioplasty
  • Kidney failure, chronic
  • Myocardial infarction
  • Stents

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

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    Ahmed, K., Jeong, M. H., Chakraborty, R., Ahmed, S., Hong, Y. J., Sim, D. S., Park, K. H., Kim, J. H., Ahn, Y., Kang, J. C., Cho, M. C., Kim, C. J., Kim, Y. J., Chae, S. C., Kim, J. H., Hur, S. H., Seong, I. W., Choi, D. H., Chae, J. K., ... Park, S. J. (2012). Coronary stents in patients with ST-elevation myocardial infarction and chronic kidney disease undergoing primary percutaneous coronary intervention. Korean Circulation Journal, 42(12), 830-838. https://doi.org/10.4070/kcj.2012.42.12.830