Document Detail

Impact of drug-eluting stent type on periprocedural myocardial necrosis.
MedLine Citation:
PMID:  21550914     Owner:  NLM     Status:  In-Data-Review    
Aims: The relationship between stent design and periprocedural myocardial infarction is unclear. The newest type of drug-eluting stent (DES), the everolimus-eluting stent (EES), has thinner strut and polymer thickness and a small amount of drug. EES use, therefore, could be related to less myocardial necrosis post-percutaneous coronary intervention (PCI). This study was undertaken to compare the amount of myocardial necrosis associated with implantation of the four DES types currently approved in the U.S. Methods and results: A cohort of 7,259 consecutive patients who underwent elective PCI with DES implantation from 2003 to 2010 was studied. Sirolimus-eluting stents were deployed in 4420, paclitaxel-eluting stents in 1858, zotarolimus-eluting stents in 308, and EES in 673. The maximum creatine phosphokinase-MB (CPK-MB) was measured post-procedure and served as the primary endpoint. Patients who received EES had the smallest CPK-MB rise (p<0.0001) among the four groups. Further, a post-PCI increase was less often large enough to meet any of the usual criteria for periprocedural myocardial infarction used in clinical studies. After adjustment for baseline and angiographic characteristics, paclitaxel-, sirolimus-, and zotarolimus-eluting stent groups more frequently exceeded the CPK-MB >5x normal limit compared with EES-treated patients (OR=2.44, p=0.01; OR=2.01, p=0.05; OR=1.80, p=0.2, respectively). Conclusions: It is plausible that EES with their superior design are associated with less periprocedural myocardial injury compared with older-generation DES.
Kohei Wakabayashi; Cedric Delhaye; Michael Mahmoudi; Loic Belle; Itsik Ben-Dor; Michael A Gaglia; William O Suddath; Lowell F Satler; Kenneth M Kent; Augusto D Pichard; Joseph Lindsay; Ron Waksman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology     Volume:  7     ISSN:  1969-6213     ISO Abbreviation:  EuroIntervention     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101251040     Medline TA:  EuroIntervention     Country:  France    
Other Details:
Languages:  eng     Pagination:  136-42     Citation Subset:  IM    
Division of Cardiology, Washington Hospital Center, Washington, DC, USA.
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