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Hur SH, Kim IC, Won KB, Cho YK, Yoon HJ, Nam CW, Kim KB, Kim MS, Park J, Rha SW, Chae SC, Kim YJ, Kim CJ, Cho MC, Jeong MH, Ahn YK, Kim HS, Ahn TH, Seung KB, Jang Y, Yoon JH, Seong IW, Hong TJ, Bae JH, Park SJ. Two-Year Safety and Efficacy of Biodegradable Polymer Drug-Eluting Stent Versus Second-Generation Durable Polymer Drug-Eluting Stent in Patients With Acute Myocardial Infarction: Data from the Korea Acute Myocardial Infarction Registry (KAMIR). Clin Cardiol 2016; 39:276-84. [PMID: 27028303 DOI: 10.1002/clc.22525] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 01/13/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Despite improved long-term safety of biodegradable polymer (BP) drug-eluting stents (DES) compared to first-generation durable polymer (DP) DES, data on the safety and efficacy of BP-DES compared with second-generation (2G) DP-DES in patients with acute myocardial infarction (AMI) are limited. HYPOTHESIS To evaluate the safety and efficacy of BP-DES compared with 2G-DP-DES in the higher stent thrombosis (ST) risk setting of AMI. METHODS A total of 3359 AMI patients who received either BP-DES (n = 261) or 2G-DP-DES (n = 3098) were included from the Korea Acute Myocardial Infarction Registry (KAMIR). Differences in baseline clinical and angiographic characteristics were adjusted using a 1:5 propensity score matching analysis (n = 261 for BP-DES and n = 1305 for 2G-DP-DES). The primary outcome was the incidence of major adverse cardiac events (MACE) including all-cause death, recurrent myocardial infarction (re-MI), and target vessel revascularization (TVR). The rate of definite or probable ST was also investigated. RESULTS In adjusted analysis, there was no significant difference between the 2 groups in baseline clinical and angiographic characteristics; 2-year MACE (10.7% and 9.9% in the BP-DES group and 2G-DP-DES group, respectively, P = 0.679); ST incidence (0.8% vs 0.9%, respectively, P = 1.0), and rates of all-cause death, re-MI, and TVR. By multivariate analysis, old age, diabetes mellitus, renal dysfunction, and left ventricular dysfunction were the independent predictors of MACE after BP-DES or 2G-DP-DES implantation. CONCLUSIONS BP-DES and 2G-DP-DES appear to have comparable 2-year safety and efficacy for the treatment of AMI. However, longer-term follow-up is needed.
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Affiliation(s)
- Seung-Ho Hur
- Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - In-Cheol Kim
- Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Ki-Bum Won
- Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Yun-Kyeong Cho
- Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Hyuck-Jun Yoon
- Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Chang-Wook Nam
- Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Kwon-Bae Kim
- Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Min-Seok Kim
- Department of Statistics, Keimyung University, Daegu, South Korea
| | - Jincheol Park
- Department of Statistics, Keimyung University, Daegu, South Korea
| | - Seung-Woon Rha
- Division of Cardiology, Korea University Guro Hospital, Seoul, South Korea
| | - Shung-Chull Chae
- Division of Cardiology, Kyungpook National University Hospital, Daegu, South Korea
| | - Young-Jo Kim
- Division of Cardiology, Yeungnam University Hospital, Daegu, South Korea
| | - Chong-Jin Kim
- Division of Cardiology, Kyung Hee University Hospital, Seoul, South Korea
| | - Myeong-Chan Cho
- Division of Cardiology, Chungbuk National University Hospital, Cheongju, South Korea
| | - Myung-Ho Jeong
- Division of Cardiology, Chonnam National University Hospital, Gwangju, South Korea
| | - Young-Keun Ahn
- Division of Cardiology, Chonnam National University Hospital, Gwangju, South Korea
| | - Hyo-Soo Kim
- Division of Cardiology, Seoul National University Hospital, Seoul, South Korea
| | - Tae-Hoon Ahn
- Division of Cardiology, Gachon University Gil Hospital, Inchon, South Korea
| | - Ki-Bae Seung
- Division of Cardiology, Catholic University Hospital, Seoul, South Korea
| | - Yangsoo Jang
- Division of Cardiology, Yonsei University Severance Hospital, Seoul, South Korea
| | - Jung-Han Yoon
- Division of Cardiology, Yonsei University Wonju Hospital, Wonju, South Korea
| | - In-Whan Seong
- Division of Cardiology, Chungnam National University Hospital, Daejeon, South Korea
| | - Taek-Jong Hong
- Division of Cardiology, Busan National University Hospital, Busan, South Korea
| | - Jang-Ho Bae
- Division of Cardiology, Konyang University Hospital, Daejeon, South Korea
| | - Seung-Jung Park
- Division of Cardiology, Ulsan University Asan Medical Center, Seoul, South Korea
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