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

Research output: Contribution to journalArticle

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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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Drug-Eluting Stents
Percutaneous Coronary Intervention
Myocardial Infarction
Stents
Propensity Score
Confidence Intervals
Thrombosis
Incidence
Sirolimus
Paclitaxel
Registries
Research Design
Safety

Keywords

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

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Cardiology and Cardiovascular Medicine

Cite this

Five-year major clinical outcomes between first-generation and secondgeneration drug-eluting stents in acute myocardial infarction patients underwent percutaneous coronary intervention. / Kim, Yong Hoon; Her, A. Y.; Rha, Seung-Woon; Choi, Byoung Geol; Choi, Se Yeon; Byun, Jae Kyeong; Baek, Ju Yeol; Choi, Woong Gil; Kang, Tae Soo; Ahn, Ji Hoon; Park, Sang Ho; Mashaly, Ahmed; Na, Jin Oh; Choi, Cheol Ung; Lim, Hong Euy; Kim, Eung Ju; Park, Chang Gyu; Seo, Hong Seog; Oh, Dong Joo.

In: Journal of Geriatric Cardiology, Vol. 15, No. 8, 01.01.2018, p. 523-533.

Research output: Contribution to journalArticle

Kim, Yong Hoon ; Her, A. Y. ; Rha, Seung-Woon ; Choi, Byoung Geol ; Choi, Se Yeon ; Byun, Jae Kyeong ; Baek, Ju Yeol ; Choi, Woong Gil ; Kang, Tae Soo ; Ahn, Ji Hoon ; Park, Sang Ho ; Mashaly, Ahmed ; Na, Jin Oh ; Choi, Cheol Ung ; Lim, Hong Euy ; Kim, Eung Ju ; Park, Chang Gyu ; Seo, Hong Seog ; Oh, Dong Joo. / Five-year major clinical outcomes between first-generation and secondgeneration drug-eluting stents in acute myocardial infarction patients underwent percutaneous coronary intervention. In: Journal of Geriatric Cardiology. 2018 ; Vol. 15, No. 8. pp. 523-533.
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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{\circledR} or endeavor sprint{\circledR}), n = 554] or 2G-DES [2G-zotarolimus (endeavor resolute{\circledR})-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.",
keywords = "Acute myocardial infarction, Clinical outcomes, Drug-eluting stent",
author = "Kim, {Yong Hoon} and Her, {A. Y.} and Seung-Woon Rha and Choi, {Byoung Geol} and Choi, {Se Yeon} and Byun, {Jae Kyeong} and Baek, {Ju Yeol} and Choi, {Woong Gil} and Kang, {Tae Soo} and Ahn, {Ji Hoon} and Park, {Sang Ho} and Ahmed Mashaly and Na, {Jin Oh} and Choi, {Cheol Ung} and Lim, {Hong Euy} and Kim, {Eung Ju} and Park, {Chang Gyu} and Seo, {Hong Seog} and Oh, {Dong Joo}",
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TY - JOUR

T1 - Five-year major clinical outcomes between first-generation and secondgeneration drug-eluting stents in acute myocardial infarction patients underwent percutaneous coronary intervention

AU - Kim, Yong Hoon

AU - Her, A. Y.

AU - Rha, Seung-Woon

AU - Choi, Byoung Geol

AU - Choi, Se Yeon

AU - Byun, Jae Kyeong

AU - Baek, Ju Yeol

AU - Choi, Woong Gil

AU - Kang, Tae Soo

AU - Ahn, Ji Hoon

AU - Park, Sang Ho

AU - Mashaly, Ahmed

AU - Na, Jin Oh

AU - Choi, Cheol Ung

AU - Lim, Hong Euy

AU - Kim, Eung Ju

AU - Park, Chang Gyu

AU - Seo, Hong Seog

AU - Oh, Dong Joo

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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.

AB - 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.

KW - Acute myocardial infarction

KW - Clinical outcomes

KW - Drug-eluting stent

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U2 - 10.11909/j.issn.1671-5411.2018.08.006

DO - 10.11909/j.issn.1671-5411.2018.08.006

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JO - Journal of Geriatric Cardiology

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