J Korean Med Sci.  2012 Nov;27(11):1339-1346. 10.3346/jkms.2012.27.11.1339.

Safety and Efficacy of Overlapping Homogenous Drug-Eluting Stents in Patients with Acute Myocardial Infarction: Results from Korea Acute Myocardial Infarction Registry

• Ahmed K
• Jeong MH
• Chakraborty R
• Hong YJ
• Sim DS
• Ahmed S
• Hwang SH
• Lee MG
• Park KH
• Kim JH
• Ahn Y
• Cho MC
• Kim CJ
• Kim YJ
• Park JC
• Kang JC
• The Korea Acute Myocardial Infarction Registry Investigators

• KMID: 2157944
• DOI: http://doi.org/10.3346/jkms.2012.27.11.1339

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.

Keyword

Drug-Eluting Stents; Myocardial Infarction; Coronary Angioplasty

MeSH Terms

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

Figure

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  Fig. 1 Cox model survival curves for 12-month major adverse cardiac events-free survival among 4 overlapping homogenous drug-eluting stents. DES, drug-eluting stent; PES, Paclitaxel-eluting stent; SES, Sirolimus-eluting stent; ZES, Zotarolimus-eluting stent; EES, Everolimus-eluting stent.

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