Comparison of Drug-Eluting Stents in Acute Myocardial Infarction Patients with Chronic Kidney Disease.
10.3904/kjim.2012.27.4.397
- Author:
Daisuke HACHINOHE
1
;
Myung Ho JEONG
;
Shigeru SAITO
;
Min Chol KIM
;
Kyung Hoon CHO
;
Khurshid AHMED
;
Seung Hwan HWANG
;
Min Goo LEE
;
Doo Sun SIM
;
Keun Ho PARK
;
Ju Han KIM
;
Young Joon HONG
;
Youngkeun AHN
;
Jung Chaee KANG
;
Jong Hyun KIM
;
Shung Chull CHAE
;
Young Jo KIM
;
Seung Ho HUR
;
In Whan SEONG
;
Taek Jong HONG
;
Donghoon CHOI
;
Myeong Chan CHO
;
Chong Jin KIM
;
Ki Bae SEUNG
;
Wook Sung CHUNG
;
Yang Soo JANG
;
Seung Woon RHA
;
Jang Ho BAE
;
Seung Jung PARK
Author Information
1. Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea. myungho@chollian.net
- Publication Type:Original Article ; Clinical Trial ; Comparative Study ; Multicenter Study ; Research Support, Non-U.S. Gov't
- Keywords:
Myocardial infarction;
Renal insufficiency;
Chronic;
Stents
- MeSH:
Aged;
*Drug-Eluting Stents/adverse effects;
Female;
Humans;
Male;
Middle Aged;
Myocardial Infarction/*etiology/mortality/*therapy;
Paclitaxel/administration & dosage;
Prospective Studies;
Registries;
Renal Insufficiency, Chronic/*complications;
Republic of Korea/epidemiology;
Sirolimus/administration & dosage/analogs & derivatives
- From:The Korean Journal of Internal Medicine
2012;27(4):397-406
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: To determine which drug-eluting stents are more effective in acute myocardial infarction (MI) patients with chronic kidney disease (CKD). METHODS: This study included a total of 3,566 acute MI survivors with CKD from the Korea Acute Myocardial Infarction Registry who were treated with stenting and followed up for 12 months: 1,845 patients who received sirolimus-eluting stents (SES), 1,356 who received paclitaxel-eluting stents (PES), and 365 who received zotarolimus-eluting stents (ZES). CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m2 calculated by the modification of diet in renal disease method. RESULTS: At the 12-month follow-up, patients receiving ZES demonstrated a higher incidence (14.8%) of major adverse cardiac events (MACEs) compared to those receiving SES (10.1%) and PES (12%, p = 0.019). The ZES patients also had a higher incidence (3.9%) of target lesion revascularization (TLR) compared to those receiving SES (1.5%) and PES (2.4%, p = 0.011). After adjusting for confounding factors, ZES was associated with a higher incidence of MACE and TLR than SES (adjusted hazard ratio [HR], 0.623; 95% confidence interval [CI], 0.442 to 0.879; p = 0.007; adjusted HR, 0.350; 95% CI, 0.165 to 0.743; p = 0.006, respectively), and with a higher rate of TLR than PES (adjusted HR, 0.471; 95% CI, 0.223 to 0.997; p = 0.049). CONCLUSIONS: Our findings suggest that ZES is less effective than SES and PES in terms of 12-month TLR, and has a higher incidence of MACE due to a higher TLR rate compared with SES, in acute MI patients with CKD.
