Five-year major clinical outcomes between first-generation and secondgeneration drug-eluting stents in acute myocardial infarction patients underwent percutaneous coronary intervention

Yong Hoon Kim, A. Y. Her, Seung-Woon Rha, Byoung Geol Choi, Se Yeon Choi, Jae Kyeong Byun, Ju Yeol Baek, Woong Gil Choi, Tae Soo Kang, Ji Hoon Ahn, Sang Ho Park, Ahmed Mashaly, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh

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Abstract

Background There were limited data comparing the major clinical outcomes between first-generation (1G)-drug eluting stents (DES) and second-generation (2G)-DES in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) during very long follow-up periods. We thought to investigate the comparative efficacy and safety of 2G-DES compared with 1G-DES in AMI patients during 5-year follow-up periods. Method A total of 1016 eligible AMI patients who underwent PCI with 1G-DES [paclitaxel-, sirolimus-, 1G-zotarolimus-eluting stent (endeavor® or endeavor sprint®), n = 554] or 2G-DES [2G-zotarolimus (endeavor resolute®)-or everolimus-eluting stent, n = 462] were enrolled. The primary endpoint was the occurrence of major adverse cardiac events (MACE) defined as total death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), non-Target vessel revascularization (Non-TVR) and the secondary endpoint was stent thrombosis (ST) at 5 years. Results Two propensity score-matched (PSM) groups (232 pairs, n = 464, C-statistic = 0.802) were generated. During the 5-year follow-up period, the cumulative incidence of TLR [hazard ratio (HR): 3.133; 95% confidence interval (CI): 1.539-6.376; P = 0.002], TVR (HR: 3.144; 95% CI: 1.596-6.192; P = 0.001) and total revascularization rate (HR: 1.874; 95% CI: 1.086-3.140; P = 0.023) were significantly higher in 1G-DES compared with 2G-DES after PSM. However, the incidence of total death, non-fatal MI and ST were similar between the two groups. Conclusion In this single-center and all-comers registry, 2G-DES's superiorities for TLR, TVR and total revascularization in AMI patients suggested during 5-year clinical follow-up periods.

Original languageEnglish
Pages (from-to)523-533
Number of pages11
JournalJournal of Geriatric Cardiology
Volume15
Issue number8
DOIs
Publication statusPublished - 2018 Jan 1

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Keywords

  • Acute myocardial infarction
  • Clinical outcomes
  • Drug-eluting stent

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Cardiology and Cardiovascular Medicine

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