ISSN 1671-5411 CN 11-5329/R
Yong Hoon Kim, Ae-Young Her, Seung-Woon Rha, Byoung Geol Choi, Se Yeon Choi, Jae Kyeong Byun, Ju Yeol Baek, Woong Gil Choi, Tae Soo Kang, Ji Hoon Ahn, Sang-Ho Park, Ahmed Mashaly, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh. Five-year major clinical outcomes between first-generation and second-generation drug-eluting stents in acute myocardial infarction patients underwent percutaneous coronary intervention. J Geriatr Cardiol 2018; 15(8): 523-533. doi: 10.11909/j.issn.1671-5411.2018.08.006
Citation: Yong Hoon Kim, Ae-Young Her, Seung-Woon Rha, Byoung Geol Choi, Se Yeon Choi, Jae Kyeong Byun, Ju Yeol Baek, Woong Gil Choi, Tae Soo Kang, Ji Hoon Ahn, Sang-Ho Park, Ahmed Mashaly, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh. Five-year major clinical outcomes between first-generation and second-generation drug-eluting stents in acute myocardial infarction patients underwent percutaneous coronary intervention. J Geriatr Cardiol 2018; 15(8): 523-533. doi: 10.11909/j.issn.1671-5411.2018.08.006

Five-year major clinical outcomes between first-generation and second-generation drug-eluting stents in acute myocardial infarction patients underwent percutaneous coronary intervention

doi: 10.11909/j.issn.1671-5411.2018.08.006
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  • Received Date: 2018-06-24
  • Rev Recd Date: 2018-06-24
  • Publish Date: 2018-08-28
  • Background There were limited data comparing the major clinical outcomes between first-generation (1G)-drug eluting stents (DES) and second-generation (2G)-DES in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) during very long follow-up periods. We thought to investigate the comparative efficacy and safety of 2G-DES compared with 1G-DES in AMI patients during 5-year follow-up periods. Methods A total of 1016 eligible AMI patients who underwent PCI with 1G-DES [paclitaxel- , sirolimus-, 1G-zotarolimus-eluting stent (endeavor? or endeavor?), n = 554] or 2G-DES [2G-zotarolimus (endeavor resolute?)- or everolimus-eluting stent, n = 462] were enrolled. The primary endpoint was the occurrence of major adverse cardiac events (MACE) defined as total death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), non-target vessel revascularization (Non-TVR) and the secondary endpoint was stent thrombosis (ST) at 5 years. Results Two propensity score-ma-tched (PSM) groups (232 pairs, n = 464, C-statistic = 0.802) were generated. During the 5-year follow-up period, the cumulative incidence of TLR [hazard ratio (HR): 3.133; 95% confidence interval (CI): 1.539–6.376; P = 0.002], TVR (HR: 3.144; 95% CI: 1.596–6.192; P = 0.001) and total revascularization rate (HR: 1.874; 95% CI: 1.086–3.140; P = 0.023) were significantly higher in 1G-DES compared with 2G-DES after PSM. However, the incidence of total death, non-fatal MI and ST were similar between the two groups. Conclusions In this single-center and all-comers registry, 2G-DES’s superiorities for TLR, TVR and total revascularization in AMI patients suggested during 5-year clinical follow-up periods.
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