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KMID : 0368120120420040266
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Korean Circulation Journal
2012 Volume.42 No. 4 p.266 ~ p.273
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Long-Term Safety and Efficacy of Sirolimus- and Paclitaxel-Eluting Stents in Patients With Acute Myocardial Infarction: Four-Year Observational Study
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Min Gye-Sik
Lee Jae-Hwan
Park Jae-Ho
Choi Ung-Lim
Lee Young-Dal
Seong Seok-Woo
Jin Seon-Ah
Park Soo-Jin
Kim Jun-Hyeong
Park Jae-Hyeong
Choi Si-Wan
Jeong Jin-Ok
Seong In-Whan
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Abstract
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Background and Objectives: The comparison of long-term clinical effects between Sirolimus-eluting stent (SES) and Paclitaxel-eluting stents (PES) for treatment of acute myocardial infarction (AMI) remains unclear. Seeking to clarify this issue, we performed a retrospective analysis to evaluate four-year clinical outcomes of SES compared to PES treated AMI patients.
Subjects and Methods: From January 2004 to August 2006, all patients with acute ST-segment elevation myocardial infarction and acute non-ST segment elevation myocardial infarction who underwent percutaneous coronary intervention (PCI) by implantation of either SES or PES were enrolled. The occurrences of cardiac and non-cardiac deaths, recurrent infarction, target vessel revascularization (TVR) and stent thrombosis were analyzed. The composite end points of these major adverse cardiac events (MACE) were also analyzed.
Results: During the study period, a total of 668 AMI patients had visited, of which 522 patients (299 with SES and 223 with PES) were enrolled. During the four-year clinical follow-up, both groups showed similar occurrences of non-cardiac death (14.6±2.2% vs. 18.3±3.0%, p=0.26); cardiac death (6.8±1.52% vs. 11.2±2.6%, p=0.39); re-infarction (3.3±1.1% vs. 6.4±1.8%, p=0.31); and stent thrombosis (3.2±1.1% vs. 5.4±1.7%, p=0.53). However, occurrences of TVR {4.0±1.2% vs. 10.0±3.0%, hazard ratio (HR)=0.498, 95% confidence interval (CI)=0.257-0.967, p=0.039} and MACE (19.4±2.5% vs. 29.4±3.5%, HR=0.645, 95% CI=0.443-0.940, p=0.021) were significantly lower in the SES population.
Conclusion: In AMI patients treated with either SES or PES implantation, the former had a significantly lower risk of TVR and MACE during four-year clinical follow-up. Rates of death, cardiac death or recurrent infarction, and stent thrombosis were similar.
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KEYWORD
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Acute myocardial infarction, Percutaneous coronary intervention, Stents
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Listed journal information
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