Paclitaxel-versus sirolimus-eluting stents for treatment of ST-segment elevation myocardial infarction

With analyses for diabetic and nondiabetic subpopulation

Youngjin Cho, Han Mo Yang, Kyung Woo Park, Woo Young Chung, Dong Joo Choi, Won Woo Seo, Kyoung Tae Jeong, Sung Chul Chae, Myoung Yong Lee, Seung Ho Hur, Jei Keon Chae, In Whan Seong, Jung Han Yoon, Suk Kyu Oh, Doo Il Kim, Keum Soo Park, Seung-Woon Rha, Yang Soo Jang, Jang Ho Bae, Taeg Jong Hong & 7 others Myeong Chan Cho, Young Jo Kim, Myung Ho Jeong, Min Jung Kim, Sue K. Park, In Ho Chae, Hyo Soo Kim

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objectives The aim of this study was to determine which drug-eluting stent (DES) is preferable for the treatment of ST-segment elevation myocardial infarction (STEMI) and to elucidate the impact of diabetes mellitus on the outcome of each DES. Background Recent studies have shown the benefit of DES in patients with STEMI. Diabetes mellitus might differentially affect outcomes of each DES. Methods We analyzed the large-scale, prospective, observational KAMIR (Korea Acute Myocardial Infarction Registry) study, which enrolled 4,416 STEMI patients (26% with diabetes) treated with paclitaxel-eluting stent (PES) or sirolimus-eluting stent (SES). Primary outcome was major adverse cardiac event (MACE), defined as a composite of mortality, nonfatal myocardial infarction, and target lesion revascularization (TLR). Results In the overall population, the MACE rate at 1 year was significantly higher in the PES than the SES group (11.6% vs. 8.6%, p = 0.014), which was mainly due to increased TLR (3.7% vs. 1.8%, p < 0.001). In the diabetic subgroup, however, the MACE rate was not significantly different between PES and SES (14.5% vs. 12.3%, p = 0.217), in contrast to the nondiabetic subgroup, where PES was inferior to SES as in the overall population. Matching by propensity-score did not significantly alter these results. For TLR, there was interaction between the type of stents and diabetes mellitus (unadjusted: p = 0.052; after propensity-score matching: p = 0.035). Conclusions The PES was inferior to the SES in the overall population, with regard to the occurrence of MACE and TLR. However, subgroup analysis for diabetic subjects showed no differences in clinical outcomes between PES and SES. These results suggest that diabetes differentially affects the outcome of first-generation DES.

Original languageEnglish
Pages (from-to)498-506
Number of pages9
JournalJACC: Cardiovascular Interventions
Volume3
Issue number5
DOIs
Publication statusPublished - 2010 May 1

Fingerprint

Sirolimus
Paclitaxel
Stents
Drug-Eluting Stents
Therapeutics
Diabetes Mellitus
Propensity Score
ST Elevation Myocardial Infarction
Myocardial Infarction
Population
Korea
Registries

Keywords

  • diabetes mellitus
  • myocardial infarction
  • stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Paclitaxel-versus sirolimus-eluting stents for treatment of ST-segment elevation myocardial infarction : With analyses for diabetic and nondiabetic subpopulation. / Cho, Youngjin; Yang, Han Mo; Park, Kyung Woo; Chung, Woo Young; Choi, Dong Joo; Seo, Won Woo; Jeong, Kyoung Tae; Chae, Sung Chul; Lee, Myoung Yong; Hur, Seung Ho; Chae, Jei Keon; Seong, In Whan; Yoon, Jung Han; Oh, Suk Kyu; Kim, Doo Il; Park, Keum Soo; Rha, Seung-Woon; Jang, Yang Soo; Bae, Jang Ho; Hong, Taeg Jong; Cho, Myeong Chan; Kim, Young Jo; Jeong, Myung Ho; Kim, Min Jung; Park, Sue K.; Chae, In Ho; Kim, Hyo Soo.

In: JACC: Cardiovascular Interventions, Vol. 3, No. 5, 01.05.2010, p. 498-506.

Research output: Contribution to journalArticle

Cho, Y, Yang, HM, Park, KW, Chung, WY, Choi, DJ, Seo, WW, Jeong, KT, Chae, SC, Lee, MY, Hur, SH, Chae, JK, Seong, IW, Yoon, JH, Oh, SK, Kim, DI, Park, KS, Rha, S-W, Jang, YS, Bae, JH, Hong, TJ, Cho, MC, Kim, YJ, Jeong, MH, Kim, MJ, Park, SK, Chae, IH & Kim, HS 2010, 'Paclitaxel-versus sirolimus-eluting stents for treatment of ST-segment elevation myocardial infarction: With analyses for diabetic and nondiabetic subpopulation', JACC: Cardiovascular Interventions, vol. 3, no. 5, pp. 498-506. https://doi.org/10.1016/j.jcin.2010.02.011
Cho, Youngjin ; Yang, Han Mo ; Park, Kyung Woo ; Chung, Woo Young ; Choi, Dong Joo ; Seo, Won Woo ; Jeong, Kyoung Tae ; Chae, Sung Chul ; Lee, Myoung Yong ; Hur, Seung Ho ; Chae, Jei Keon ; Seong, In Whan ; Yoon, Jung Han ; Oh, Suk Kyu ; Kim, Doo Il ; Park, Keum Soo ; Rha, Seung-Woon ; Jang, Yang Soo ; Bae, Jang Ho ; Hong, Taeg Jong ; Cho, Myeong Chan ; Kim, Young Jo ; Jeong, Myung Ho ; Kim, Min Jung ; Park, Sue K. ; Chae, In Ho ; Kim, Hyo Soo. / Paclitaxel-versus sirolimus-eluting stents for treatment of ST-segment elevation myocardial infarction : With analyses for diabetic and nondiabetic subpopulation. In: JACC: Cardiovascular Interventions. 2010 ; Vol. 3, No. 5. pp. 498-506.
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abstract = "Objectives The aim of this study was to determine which drug-eluting stent (DES) is preferable for the treatment of ST-segment elevation myocardial infarction (STEMI) and to elucidate the impact of diabetes mellitus on the outcome of each DES. Background Recent studies have shown the benefit of DES in patients with STEMI. Diabetes mellitus might differentially affect outcomes of each DES. Methods We analyzed the large-scale, prospective, observational KAMIR (Korea Acute Myocardial Infarction Registry) study, which enrolled 4,416 STEMI patients (26{\%} with diabetes) treated with paclitaxel-eluting stent (PES) or sirolimus-eluting stent (SES). Primary outcome was major adverse cardiac event (MACE), defined as a composite of mortality, nonfatal myocardial infarction, and target lesion revascularization (TLR). Results In the overall population, the MACE rate at 1 year was significantly higher in the PES than the SES group (11.6{\%} vs. 8.6{\%}, p = 0.014), which was mainly due to increased TLR (3.7{\%} vs. 1.8{\%}, p < 0.001). In the diabetic subgroup, however, the MACE rate was not significantly different between PES and SES (14.5{\%} vs. 12.3{\%}, p = 0.217), in contrast to the nondiabetic subgroup, where PES was inferior to SES as in the overall population. Matching by propensity-score did not significantly alter these results. For TLR, there was interaction between the type of stents and diabetes mellitus (unadjusted: p = 0.052; after propensity-score matching: p = 0.035). Conclusions The PES was inferior to the SES in the overall population, with regard to the occurrence of MACE and TLR. However, subgroup analysis for diabetic subjects showed no differences in clinical outcomes between PES and SES. These results suggest that diabetes differentially affects the outcome of first-generation DES.",
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author = "Youngjin Cho and Yang, {Han Mo} and Park, {Kyung Woo} and Chung, {Woo Young} and Choi, {Dong Joo} and Seo, {Won Woo} and Jeong, {Kyoung Tae} and Chae, {Sung Chul} and Lee, {Myoung Yong} and Hur, {Seung Ho} and Chae, {Jei Keon} and Seong, {In Whan} and Yoon, {Jung Han} and Oh, {Suk Kyu} and Kim, {Doo Il} and Park, {Keum Soo} and Seung-Woon Rha and Jang, {Yang Soo} and Bae, {Jang Ho} and Hong, {Taeg Jong} and Cho, {Myeong Chan} and Kim, {Young Jo} and Jeong, {Myung Ho} and Kim, {Min Jung} and Park, {Sue K.} and Chae, {In Ho} and Kim, {Hyo Soo}",
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T1 - Paclitaxel-versus sirolimus-eluting stents for treatment of ST-segment elevation myocardial infarction

T2 - With analyses for diabetic and nondiabetic subpopulation

AU - Cho, Youngjin

AU - Yang, Han Mo

AU - Park, Kyung Woo

AU - Chung, Woo Young

AU - Choi, Dong Joo

AU - Seo, Won Woo

AU - Jeong, Kyoung Tae

AU - Chae, Sung Chul

AU - Lee, Myoung Yong

AU - Hur, Seung Ho

AU - Chae, Jei Keon

AU - Seong, In Whan

AU - Yoon, Jung Han

AU - Oh, Suk Kyu

AU - Kim, Doo Il

AU - Park, Keum Soo

AU - Rha, Seung-Woon

AU - Jang, Yang Soo

AU - Bae, Jang Ho

AU - Hong, Taeg Jong

AU - Cho, Myeong Chan

AU - Kim, Young Jo

AU - Jeong, Myung Ho

AU - Kim, Min Jung

AU - Park, Sue K.

AU - Chae, In Ho

AU - Kim, Hyo Soo

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N2 - Objectives The aim of this study was to determine which drug-eluting stent (DES) is preferable for the treatment of ST-segment elevation myocardial infarction (STEMI) and to elucidate the impact of diabetes mellitus on the outcome of each DES. Background Recent studies have shown the benefit of DES in patients with STEMI. Diabetes mellitus might differentially affect outcomes of each DES. Methods We analyzed the large-scale, prospective, observational KAMIR (Korea Acute Myocardial Infarction Registry) study, which enrolled 4,416 STEMI patients (26% with diabetes) treated with paclitaxel-eluting stent (PES) or sirolimus-eluting stent (SES). Primary outcome was major adverse cardiac event (MACE), defined as a composite of mortality, nonfatal myocardial infarction, and target lesion revascularization (TLR). Results In the overall population, the MACE rate at 1 year was significantly higher in the PES than the SES group (11.6% vs. 8.6%, p = 0.014), which was mainly due to increased TLR (3.7% vs. 1.8%, p < 0.001). In the diabetic subgroup, however, the MACE rate was not significantly different between PES and SES (14.5% vs. 12.3%, p = 0.217), in contrast to the nondiabetic subgroup, where PES was inferior to SES as in the overall population. Matching by propensity-score did not significantly alter these results. For TLR, there was interaction between the type of stents and diabetes mellitus (unadjusted: p = 0.052; after propensity-score matching: p = 0.035). Conclusions The PES was inferior to the SES in the overall population, with regard to the occurrence of MACE and TLR. However, subgroup analysis for diabetic subjects showed no differences in clinical outcomes between PES and SES. These results suggest that diabetes differentially affects the outcome of first-generation DES.

AB - Objectives The aim of this study was to determine which drug-eluting stent (DES) is preferable for the treatment of ST-segment elevation myocardial infarction (STEMI) and to elucidate the impact of diabetes mellitus on the outcome of each DES. Background Recent studies have shown the benefit of DES in patients with STEMI. Diabetes mellitus might differentially affect outcomes of each DES. Methods We analyzed the large-scale, prospective, observational KAMIR (Korea Acute Myocardial Infarction Registry) study, which enrolled 4,416 STEMI patients (26% with diabetes) treated with paclitaxel-eluting stent (PES) or sirolimus-eluting stent (SES). Primary outcome was major adverse cardiac event (MACE), defined as a composite of mortality, nonfatal myocardial infarction, and target lesion revascularization (TLR). Results In the overall population, the MACE rate at 1 year was significantly higher in the PES than the SES group (11.6% vs. 8.6%, p = 0.014), which was mainly due to increased TLR (3.7% vs. 1.8%, p < 0.001). In the diabetic subgroup, however, the MACE rate was not significantly different between PES and SES (14.5% vs. 12.3%, p = 0.217), in contrast to the nondiabetic subgroup, where PES was inferior to SES as in the overall population. Matching by propensity-score did not significantly alter these results. For TLR, there was interaction between the type of stents and diabetes mellitus (unadjusted: p = 0.052; after propensity-score matching: p = 0.035). Conclusions The PES was inferior to the SES in the overall population, with regard to the occurrence of MACE and TLR. However, subgroup analysis for diabetic subjects showed no differences in clinical outcomes between PES and SES. These results suggest that diabetes differentially affects the outcome of first-generation DES.

KW - diabetes mellitus

KW - myocardial infarction

KW - stents

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