Safety and efficacy of overlapping homogenous drug-eluting stents in patients with acute myocardial infarction: results from Korea Acute Myocardial Infarction Registry

J Korean Med Sci. 2012 Nov;27(11):1339-46. doi: 10.3346/jkms.2012.27.11.1339. Epub 2012 Oct 30.

Abstract

The aim of this study was to compare safety and efficacy of 4 homogenous overlapping drug-eluting stents (DES) in acute myocardial infarction (AMI) patients. We selected 1,349 consecutive patients (62.1 ± 14.9 yr, 69.4% male) who received homogenous overlapping DESs in diffuse de novo coronary lesions from Korea Acute Myocardial Infarction Registry from April 2006 through September 2010. They were divided into 4 groups based on type of DES implanted - Paclitaxel (PES), Sirolimus (SES), Zotarolimus (ZES) and Everolimus (EES)-eluting stents. Primary endpoint was 12-month MACE. We also studied EES versus other DESs (PES + SES + ZES). Mean stent length was 26.2 ± 7.5 mm and mean stent diameter was 3.1 ± 0.4 mm. Average number of stents used per vessel was 2.2 ± 0.5. Incidence of major adverse cardiac events (MACE) in PES, SES, ZES, and EES groups were 9.5%, 9.2%, 7.5%, and 3.8%, respectively (P = 0.013). In EES group, overall MACE and repeat revascularization were lowest, and no incidence of stent thrombosis was observed. Non-fatal MI was highest in PES, almost similar in SES and EES with no incidence in ZES group (P = 0.044). Cox proportional hazard analysis revealed no differences in the incidence of primary endpoint (P = 0.409). This study shows no significant differences in 12-month MACE among 4 groups.

Keywords: Coronary Angioplasty; Drug-Eluting Stents; Myocardial Infarction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Phytogenic / adverse effects
  • Antineoplastic Agents, Phytogenic / therapeutic use*
  • Coronary Angiography
  • Drug-Eluting Stents / adverse effects*
  • Everolimus
  • Female
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use*
  • Male
  • Middle Aged
  • Myocardial Infarction / drug therapy*
  • Myocardial Infarction / mortality
  • Myocardial Infarction / pathology
  • Myocardial Revascularization
  • Paclitaxel / adverse effects
  • Paclitaxel / therapeutic use
  • Proportional Hazards Models
  • Registries
  • Republic of Korea
  • Sirolimus / adverse effects
  • Sirolimus / analogs & derivatives
  • Sirolimus / therapeutic use
  • Survival Analysis

Substances

  • Antineoplastic Agents, Phytogenic
  • Immunosuppressive Agents
  • Everolimus
  • zotarolimus
  • Paclitaxel
  • Sirolimus