Mi Seon Ji1, Myung Ho Jeong2, Young Keun Ahn1, Sang Hyung Kim1, Young Jo Kim3, Shung Chull Chae4, Taek Jong Hong5, In Whan Seong6, Jei Keon Chae7, Chong Jin Kim8, Myeong Chan Cho9, Seung-Woon Rha10, Jang Ho Bae11, Ki Bae Seung12, Seung Jung Park13, Seung Ho Hur14. 1. Chonnam National University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea. 2. Chonnam National University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea. Electronic address: myungho@chollian.net. 3. YeungnamUniversityHospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea. 4. Kyungpook National University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea. 5. Pusan National University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea. 6. Chungnam National University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea. 7. Chonbuk National University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea. 8. Kyung Hee University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea. 9. Chungbuk National University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea. 10. Korea University Guro Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea. 11. Konyang University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea. 12. Catholic University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea. 13. Asan Medical Center, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea. 14. Keimyung University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea.
Abstract
BACKGROUND: Despite common use of second-generation drug-eluting stents in treating patients with coronary artery disease, there is lack of data comparing these stents exclusively in patients with acute myocardial infarction (AMI), especially with metabolic syndrome (MetS), which is highly prevalent in AMI and potential to worsen clinical outcomes. The aim of this study was to compare clinical outcomes of everolimus-eluting stent (EES) and Resolute-zotarolimus-eluting stent (R-ZES) in AMI patients with MetS, in terms of stent-related and patient-related outcomes. METHODS: A total of 3942 AMI patients in the KAMIR (Korea Acute Myocardial Infarction Registry) were grouped according to the presence of MetS and stent type: EES (N=1582) and R-ZES (N=255) in MetS (1837). Target lesion failure (TLF) and patient-oriented composite events (POCE) at 1 year were evaluated. RESULTS: In MetS patients, TLF (3.7% vs. 2.7%, p=0.592) and POCE (7.9% vs. 6.7%, p=0.764) were similar between EES and R-ZES. Also in Non-MetS patients, TLF (3.9% vs. 3.1%, p=0.307) and POCE (6.4% vs. 7.3%, p=0.866) were similar between 2 groups. TLF was similar between MetS and Non-MetS patients (3.6% vs. 3.8%), while POCEs (7.7% vs. 6.6%) were higher in MetS. Propensity-score matching analysis showed similar results between stent groups in MetS and Non-MetS. In multivariate analysis, left ventricular ejection fraction and symptom-to-door time were independent predictors of TLF and POCE in MetS patients with AMI. CONCLUSIONS: In MetS patients with AMI, EES and R-ZES showed excellent performance and safety. However, patient-oriented composite events were relatively high, suggesting more efforts to improve them.
BACKGROUND: Despite common use of second-generation drug-eluting stents in treating patients with coronary artery disease, there is lack of data comparing these stents exclusively in patients with acute myocardial infarction (AMI), especially with metabolic syndrome (MetS), which is highly prevalent in AMI and potential to worsen clinical outcomes. The aim of this study was to compare clinical outcomes of everolimus-eluting stent (EES) and Resolute-zotarolimus-eluting stent (R-ZES) in AMI patients with MetS, in terms of stent-related and patient-related outcomes. METHODS: A total of 3942 AMI patients in the KAMIR (Korea Acute Myocardial Infarction Registry) were grouped according to the presence of MetS and stent type: EES (N=1582) and R-ZES (N=255) in MetS (1837). Target lesion failure (TLF) and patient-oriented composite events (POCE) at 1 year were evaluated. RESULTS: In MetS patients, TLF (3.7% vs. 2.7%, p=0.592) and POCE (7.9% vs. 6.7%, p=0.764) were similar between EES and R-ZES. Also in Non-MetS patients, TLF (3.9% vs. 3.1%, p=0.307) and POCE (6.4% vs. 7.3%, p=0.866) were similar between 2 groups. TLF was similar between MetS and Non-MetS patients (3.6% vs. 3.8%), while POCEs (7.7% vs. 6.6%) were higher in MetS. Propensity-score matching analysis showed similar results between stent groups in MetS and Non-MetS. In multivariate analysis, left ventricular ejection fraction and symptom-to-door time were independent predictors of TLF and POCE in MetS patients with AMI. CONCLUSIONS: In MetS patients with AMI, EES and R-ZES showed excellent performance and safety. However, patient-oriented composite events were relatively high, suggesting more efforts to improve them.
Authors: Rik Rozemeijer; Ivar G van Muiden; Stefan Koudstaal; Geert E Leenders; Leo Timmers; Saskia Z Rittersma; Adriaan O Kraaijeveld; Pieter A Doevendans; Michiel Voskuil; Pieter R Stella Journal: Catheter Cardiovasc Interv Date: 2019-01-02 Impact factor: 2.692