C124. Kim KH, Koo BK, Min HS, Park SK, Kim CH, Park KW, Park BJ, Jeong MH, Cho MC, Lee SR, Chae SC, Seong IW, Choi DJ, Kim HS; Comparison of drug-eluting versus bare-metal stent implantation in ST-elevation myocardial infarction patients with renal insufficiency: Results from the national registry in Korea. Int J Cardiol. 2012;154(1)71-77.
(Abstract)
Introduction: It is unknown whether drug-eluting stents (DES), in comparison with bare-metal stents (BMS), improve clinical outcomes of ST-elevation myocardial infarction (STEMI) patients with renal insufficiency. We aimed to compare the clinical outcomes of BMS versus DES, as well as sirolimus-eluting stents (SES) versus paclitaxel-eluting stents (PES), in STEMI patients with renal insufficiency.
Methods: From the Korea Acute Myocardial Infarction Registry, 874 STEMI patients with renal insufficiency (glomerular filtration rate b60 ml/min) comprising 116 patientswithBMSand 758 patientswithDES (430 SES and328 PES) implantationwere selected. Major adverse cardiac events (MACE)within 1 year, defined as composite of all-cause mortality, nonfatalmyocardial infarction and target lesion revascularization were compared. In addition to multivariate adjusted analysis, propensity analysis for stent choice was performed.
Results: With a median follow-up of 342 days, 116 MACE occurred. MACE was more frequent in the BMS group than in the DES group before (HR [95% CI]=2.3 [1.3–3.8]) and after propensity scorematching (HR [95% CI]=2.0 [1.0–3.8]). The difference ofMACE wasmainly driven by a higher rate of target lesion revascularization rate in the BMS group. In comparison between SES and PES, there was no significant difference between the 2 groups in propensity score-matched populations (HR [95% CI]=0.7 [0.4–1.1]).
Conclusions: In STEMI patients with renal insufficiency, DES implantation exhibits a favorable 1 year clinical outcomes than BMS implantation, however, no difference was found between SES and PES.
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DATE : 16-03-14 14:13
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