Document Detail


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.
MedLine Citation:
PMID:  20888053     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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 <60ml/min) comprising 116 patients with BMS and 758 patients with DES (430 SES and 328 PES) implantation were selected. Major adverse cardiac events (MACE) within 1year, defined as composite of all-cause mortality, nonfatal myocardial 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 342days, 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 score matching (HR [95% CI]=2.0 [1.0-3.8]). The difference of MACE was mainly 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 1year clinical outcomes than BMS implantation, however, no difference was found between SES and PES.
Authors:
Kyung-Hee Kim; Bon-Kwon Koo; Hee-Suk Min; Sue K Park; Chi-Hoon Kim; Kyung-Woo Park; Byung-Joo Park; Myung-Ho Jeong; Myeong-Chan Cho; Sang-Rok Lee; Sung-Chull Chae; In-Whan Seong; Dong-Ju Choi; Hyo-Soo Kim
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Publication Detail:
Type:  Journal Article     Date:  2010-10-02
Journal Detail:
Title:  International journal of cardiology     Volume:  154     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  71-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Internal Medicine, Seoul National University Hospital, Republic of Korea.
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