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KMID : 1151820120060010005
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Journal of the Korean Society of Radiology
2012 Volume.6 No. 1 p.5 ~ p.10
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The evaluation for Clinical usefulness and Safety of Sirolimus-eluting stent and Paclitaxel-Eluting Stents In Patients With Acute Myocardial Infarction
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Min Gye-Sik
Han Man-Seok
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Abstract
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There is a still unsettled issue about the comparison of long-term clinical effects between sirolimus- (SES) and paclitaxel-eluting stents (PES) for the patients with acute myocardial infarction (AMI). Therefore, we performed a retrospective analysis to evaluate the 4-year clinical outcome of SES as compared with PES after percutaneous coronary intervention (PCI) in patients with AMI. From January 2004 to August 2006, all consecutive patients with acute ST-segment elevation myocardial infarction (STEMI) underwent primary PCI and acute NSTEMI underwent PCI by implantation either SES or PES were enrolled. The occurrence of death, cardiac death, recurrent infarction, target vessel revascularization (TVR) and stent thrombosis were analyzed. The composite of major adverse cardiac events (MACE; death, recurrent infarction and TVR) were also analyzed. During the study period, total 668 AMI patients had visited. Of them, total 522 patients (299 with SES and 223 with PES) were enrolled. During 4-year clinical follow-up, there were similar occurrences of death (18.3±3.0% vs. 14.6±2.2%, p=0.26), cardiac death (11.2±2.6% vs. 6.8±1.52%, p=0.39), re-infarction (6.4±1.8% vs. 3.3±1.1%, p=0.31), and stent thrombosis (5.4±1.7% vs. 3.2±1.1%, p=0.53) between the two groups, consecutively. The occurrences of TVR (10.0±3.0% vs. 4.0±1.2%, p=0.008) and MACE (29.4±3.5% vs. 19.4±2.5%, p=0.003) were significantly higher in patients treated with PES than SES. In AMI patients treated with either SES or PES implantation, SES had a significantly lower risk of TVR and MACE during 4-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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