Drug-eluting vs. bare-metal stents for treatment of acute myocardial infarction with renal insufficiency: Results from Korea acute myocardial infarction registry

Eun Hui Bae, Sang Yeob Lim, Young Hwan Choi, Sang Heon Suh, Kyung Hoon Cho, Joon Seok Choi, Chang Seong Kim, Jeong Woo Park, Seong Kwon Ma, Myung Ho Jeong, Soo Wan Kim

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13 Citations (Scopus)

Abstract

Background: Patients with chronic kidney disease have had conflicting results between drug-eluting stents (DES) and bare-metal stents (BMS). The aim of the present study was to determine whether DES is preferable for the treatment of acute myocardial infarction (AMI) with renal insufficiency, and to elucidate the impact of diabetes mellitus (DM) on outcomes of each stent. Methods and Results: As a part of the Korea Acute Myocardial Infarction Registry (KAMIR), 2,175 AMI patients with renal insufficiency (glomerular filtration rate <60 ml/min) comprising 208 patients with BMS and 1,967 DES implantation were selected. Primary outcome was major adverse cardiac event (MACE), defined as a composite of mortality, nonfatal myocardial infarction, and target lesion revascularization. In the overall population, the MACE rate at 1 year was significantly higher in the BMS group than that of DES (44% vs. 26%, P<0.05), which was mainly due to death rather than repeat intervention (44% vs. 26%, P<0.05). In the diabetic group with DES implantation, the MACE rate was higher compared with the DES group without DM, mainly due to repeat intervention (5% vs. 8%, P<0.05). Conclusions: In AMI patients with renal insufficiency, DES implantation exhibits a favorable 1-year clinical outcome than BMS implantation, and subgroup analysis for diabetic subjects showed worse outcomes in the DM group with implanted DES.

Original languageEnglish
Pages (from-to)2798-2804
Number of pages7
JournalCirculation Journal
Volume75
Issue number12
DOIs
Publication statusPublished - 2011 Dec 7

Keywords

  • Acute myocardial infarction
  • Bare-metal stent
  • Drug-eluting stent
  • Glomerular filtration rate
  • Major adverse cardiac event

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Bae, E. H., Lim, S. Y., Choi, Y. H., Suh, S. H., Cho, K. H., Choi, J. S., Kim, C. S., Park, J. W., Ma, S. K., Jeong, M. H., & Kim, S. W. (2011). Drug-eluting vs. bare-metal stents for treatment of acute myocardial infarction with renal insufficiency: Results from Korea acute myocardial infarction registry. Circulation Journal, 75(12), 2798-2804. https://doi.org/10.1253/circj.CJ-11-0586