Long-Term Safety and Efficacy of Sirolimus- and Paclitaxel-Eluting Stents in Patients With Acute Myocardial Infarction: Four-Year Observational Study.
10.4070/kcj.2012.42.4.266
- Author:
Gye Sik MIN
1
;
Jae Hwan LEE
;
Jae Ho PARK
;
Ung Lim CHOI
;
Young Dal LEE
;
Seok Woo SEONG
;
Seon Ah JIN
;
Soo Jin PARK
;
Jun Hyeong KIM
;
Jae Hyeong PARK
;
Si Wan CHOI
;
Jin Ok JEONG
;
In Whan SEONG
Author Information
1. Department of Cardiology, Chungnam National University School of Medicine, Daejeon, Korea. myheart@cnu.ac.kr
- Publication Type:Original Article
- Keywords:
Acute myocardial infarction;
Percutaneous coronary intervention;
Stents
- MeSH:
Death;
Follow-Up Studies;
Glycosaminoglycans;
Humans;
Infarction;
Myocardial Infarction;
Percutaneous Coronary Intervention;
Retrospective Studies;
Stents;
Thrombosis
- From:Korean Circulation Journal
2012;42(4):266-273
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: The comparison of long-term clinical effects between Sirolimus-eluting stent (SES) and Paclitaxel-eluting stents (PES) for treatment of acute myocardial infarction (AMI) remains unclear. Seeking to clarify this issue, we performed a retrospective analysis to evaluate four-year clinical outcomes of SES compared to PES treated AMI patients. SUBJECTS AND METHODS: From January 2004 to August 2006, all patients with acute ST-segment elevation myocardial infarction and acute non-ST segment elevation myocardial infarction who underwent percutaneous coronary intervention (PCI) by implantation of either SES or PES were enrolled. The occurrences of cardiac and non-cardiac deaths, recurrent infarction, target vessel revascularization (TVR) and stent thrombosis were analyzed. The composite end points of these major adverse cardiac events (MACE) were also analyzed. RESULTS: During the study period, a total of 668 AMI patients had visited, of which 522 patients (299 with SES and 223 with PES) were enrolled. During the four-year clinical follow-up, both groups showed similar occurrences of non-cardiac death (14.6+/-2.2% vs. 18.3+/-3.0%, p=0.26); cardiac death (6.8+/-1.52% vs. 11.2+/-2.6%, p=0.39); re-infarction (3.3+/-1.1% vs. 6.4+/-1.8%, p=0.31); and stent thrombosis (3.2+/-1.1% vs. 5.4+/-1.7%, p=0.53). However, occurrences of TVR {4.0+/-1.2% vs. 10.0+/-3.0%, hazard ratio (HR)=0.498, 95% confidence interval (CI)=0.257-0.967, p=0.039} and MACE (19.4+/-2.5% vs. 29.4+/-3.5%, HR=0.645, 95% CI=0.443-0.940, p=0.021) were significantly lower in the SES population. CONCLUSION: In AMI patients treated with either SES or PES implantation, the former had a significantly lower risk of TVR and MACE during four-year clinical follow-up. Rates of death, cardiac death or recurrent infarction, and stent thrombosis were similar.
