임상

HOME > 연구실적 > 임상 > 논문
 
작성일 : 16-03-14 03:02
논문번호 178
논문제목(영문) Comparisons of everolimus and Paclitaxel-eluting stents in patients with acute myocardial infarction.
국내외구분 국외 SCI여부 SCI(E)
연구책임자역할 공저자
주저자명 Chen KY
교신저자명 Rha SW
공동저자명 Chen KY, Rha SW, Li YJ, Li GP, Oh DJ, Jeong MH, Kim YJ, Hur SH, Bae JH, Ahn TH;
게제년월일 2015-04-01
ISSN 0896-4327
Impact Factor 1.183
학술지명 Journal of interventional cardiology
서지사항 0집 / 28권 / 2호,   페이지(147 - 156)
요약초록문
(Abstract) 입력		 Background: Biodegradable polymer drug-eluting stent (BP-DES) reduced the risk of stent thrombosis (ST) compared with firstgeneration durable polymer (DP)-DES. Limited data are available comparing second-generation (2G) DP-DES with BP-DES in patients with acute myocardial infarction (AMI).
Methods: A total of 3,207 AMI patients received either 2G DP-DES (n=2,965) or BP-DES (n=242) were included from Korea Acute Myocardial Infarction Registry (KAMIR) between January 2008 and May 2012. To adjust baseline characteristics, a 1:5 propensity score matching (PSM) was performed (1,210 patients for 2G DP-DES and 242 patients for BP-DES). The primary end point was the incidence of major adverse cardiacBACKGROUND:
It has been established that the newer-generation drug-eluting stent (DES) everolimus-eluting stent (EES) is superior to the first-generation DES paclitaxel-eluting stent (PES). However, the advantages of EES over PES in the setting of acute myocardial infarction (AMI) need to be fully elucidated.
METHODS:
The present analysis enrolled 2,911 AMI patients receiving PES (n = 1,210) or EES (n = 1,701) in a large-scale, prospective, multicenter Korea Acute Myocardial Infarction Registry (KAMIR). Propensity score matching was used to adjust for baseline biases in clinical and angiographic characteristics, yielding a total of 2,398 patients (1,199 receiving PES and 1,199 receiving EES). Various clinical outcomes at 1 year were compared between the two propensity score matched groups. Target lesion failure (TLF) was defined as the composite of cardiac death, recurrent nonfatal myocardial infarction (Re-MI), or target lesion revascularization (TLR).
RESULTS:
Baseline clinical and angiographic characteristics were comparable between the two groups after propensity score matching. Clinical outcomes of the propensity score matched patients showed that the rates of in-hospital and 1-year cardiac and all-cause death were similar between the two groups. But patients in the EES group had significantly lower incidences of Re-MI (1.4% vs 2.8%, P = 0.002), TLR (1.2% vs 3.1%, P = 0.001), TLF (6.4% vs 10.2%, P = 0.001), and probable or definite stent thrombosis (0.3% vs 1.8%, P < 0.001) than did those in the PES group.
CONCLUSIONS:
The present propensity matched analysis suggests that the use of EES in the setting of AMI appears to be superior to PES in reducing TLF, and stent thrombosis. events (MACE) including all-cause death, recurrent myocardial infarction (re-MI), and target vessel revascularization (TVR). The rate of definite or probable ST was also investigated.
Results: After PSM, there was no difference of baseline characteristics between the 2 groups. Two-year MACE was not different between the 2 groups (3.8% vs. 4.1%, p=0.910). The incidence of ST was also not different (1.0% vs. 0.4%, p=0.514). By multivariate analysis, age, diabetes mellitus, post-procedural TIMI flow were the independent predictors of MACE.
Conclusion: 2G DP-DES has comparable safety and efficacy for AMI patients compared with BP-DES up to 2 years follow-up. However, longer-term follow-up will be needed to evaluate the difference of each polymer in this patient subset.
파일  C178.+J+Interv+Cardiol.+2015;28(2)147-156..pdf (854.3K) DATE : 2021-05-26 11:49:48