KMID : 0882420150890040418
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Korean Journal of Medicine 2015 Volume.89 No. 4 p.418 ~ p.427
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Clinical Outcome Comparison of Everolimus- and Biolimus-eluting Stents in Patients with Acute Myocardial Infarction
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Park In-Cheol
Jeong Myung-Ho Kim In-Soo Rhee Jung-Ae Choi Jin-Su Park In-Hyae Chai Leem-Soon Jeong Yun-Ah Hyun Dae-Yong Jeong Hae-Chang Lee Ki-Hong Park Keun-Ho Sim Doo-Sun Kim Kye-Hoon Hong Young-Joon Park Hyung-Wook Kim Ju-Han Ahn Young-Keun Cho Jeong-Gwan Park Jong-Chun
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Abstract
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Background/Aims: We compared the efficacy and safety of the second-generation everolimus-eluting stent (EES) and the third generation biolimus-eluting stent (BES) in patients with acute myocardial infarction (AMI).
Methods: We analyzed 629 consecutive patients (mean age 65.1 ¡¾ 11.2 years, 426 males) with AMI undergoing percutaneous coronary intervention from February 2008 to April 2012. They were divided into two groups according to stent type (EES group, n = 426; BES group, n = 203). The primary end-point was 2-year major adverse cardiac events (MACEs), defined as the composite of all-cause death, myocardial infarction, target vessel revascularization, non-target vessel revascularization and target lesion revascularization. The secondary end-point was 2-year target lesion failure (TLF).
Results: There were no significant differences in baseline characteristics, except that the patients with EES had a significantly higher prevalence of diabetes mellitus (34.7 vs. 22.7%, p = 0.002) and were older (67.1 ¡¾ 11.3 vs. 64 ¡¾ 12.9 years, p = 0.039) compared with the patients with BES. After propensity score matching, 2-year clinical outcomes showed no differences in composite MACEs or TLF between the two groups. Multivariate Cox regression analysis showed that stent type was not a predictor of 2-year mortality or MACEs. However, older age (hazard ratio [HR] 1.037, 95% confidence interval [CI] 1.014-1.060, p = 0.001), diabetes mellitus (HR 2.247, 95% CI 1.426-3.539, p = 0.001) and a left ventricular ejection fraction ¡Â 45% (HR 3.007, 95% CI 1.978-4.573, p = 0.001) were independent predictors for 2-year MACEs in patients undergoing EES or BES.
Conclusions: Patients with BES had similar clinical 2-year outcomes compared with EES patients with AMI.
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KEYWORD
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Myocardial infarction, Stents, Prognosis
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