Clinical Outcomes of Drug-Eluting Stents vs. Bare-Metal Stents in Acute Myocardial Infarction Patients Under Dialysis　– A Nationwide Cohort Study –

Chen, Dong‐Yi; Mao, Chun-Tai; Tsai, Ming-Lung; Hsieh, Ming‐Jer; Lin, Yu‐Sheng; Cherng, Wen‐Jin; Wen, Ming‐Shien; Wang, Chao-Hung; Hsieh, I‐Chang; Hung, Ming‐Jui; Chen, Chun‐Chi; Chen, Tien-Hsing

doi:10.1253/circj.cj-15-0778

Cited by 13 publications

(8 citation statements)

References 32 publications

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“…Among these articles, 81 were retrieved for detailed evaluation. In total, 38 articles met the inclusion criteria (Figure ), including 6 RCTs (1 real RCT, 1 pooled analysis of RCTs, and 4 post hoc analyses of an RCT) and 32 OSs (26 retrospective cohort studies and 6 prospective cohort studies).…”

Section: Resultsmentioning

confidence: 99%

Comparison of Drug‐Eluting and Bare Metal Stents in Patients With Chronic Kidney Disease: An Updated Systematic Review and Meta‐Analysis

Tang

Zhang

et al. 2016

JAHA

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BackgroundDrug‐eluting stents (DESs) and bare metal stents (BMSs) are both recommended to improve coronary revascularization and to treat coronary artery disease in patients with chronic kidney disease (CKD). However, the potential superiority of DESs over BMSs for reducing the incidence of long‐term major adverse cardiovascular events and mortality in CKD patients has not been established, and the results remain controversial. We aimed to systematically assess and quantify the total weight of evidence regarding the use of DESs versus BMSs in CKD patients.Methods and ResultsIn this systematic review and conventional meta‐analysis, electronic studies published in any language until May 20, 2016, were systematically searched through PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials. We included randomized controlled trials and observational studies comparing outcomes in CKD patients with DESs versus BMSs and extracted data in a standard form. Pooled odd ratios and 95% CIs were calculated using random‐ and fixed‐effects models. Finally, 38 studies involving 123 396 patients were included. The use of DESs versus BMSs was associated with significant reductions in major adverse cardiovascular events (pooled odds ratio 0.75; 95% CI, 0.64–0.88; P<0.001), all‐cause mortality (odds ratio 0.81; 95% CI, 0.73–0.90; P<0.001), myocardial infarction, target‐lesion revascularization, and target‐vessel revascularization. The superiority of DESs over BMSs for improving clinical outcomes was attenuated in randomized controlled trials.ConclusionsThe use of DESs significantly improves the above outcomes in CKD patients. Nevertheless, large‐sized randomized controlled trials are necessary to determine the real effect on CKD patients and whether efficacy differs by type of DES.

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Section: Resultsmentioning

confidence: 99%

Comparison of Drug‐Eluting and Bare Metal Stents in Patients With Chronic Kidney Disease: An Updated Systematic Review and Meta‐Analysis

Tang

Zhang

et al. 2016

JAHA

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“…Controversy remains regarding the efficacy of DES compared to BMS implantation in dialysis patients. While a study has demonstrated a reduced risk of recurrent MI, cardiovascular death, and all-cause mortality with the use of DESs compared with BMSs [52], none of the previous studies has focused on AF patients on dialysis with first AMI as the study population. Dialysis is reported to be an independent predictor of late catch-up phenomenon [53].…”

Section: Discussionmentioning

confidence: 99%

“…We defined cardiovascular death according to the criteria of the Standardized Definitions for Cardiovascular and Stroke Endpoint Events in Clinical Trials by the US Food and Drug Administration [31]. Secondary cardiac and safety outcomes were defined as being admitted with a principal diagnosis of any stroke, hemorrhagic stroke, unspecified stroke, gastrointestinal bleeding, major bleeding and heart failure hospitalization [6,28,32].…”

Section: Outcomementioning

confidence: 99%

Drug-eluting versus bare-metal stents for first myocardial infarction in patients with atrial fibrillation: A nationwide population-based cohort study

Chang

Chen

et al. 2020

PLoS ONE

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Background Acute myocardial infarction (AMI) complicates the clinical management of atrial fibrillation (AF) because coronary stenting may influence subsequent antithrombotic therapy. We investigated the use of a bare-metal stent (BMS) or a drug-eluting stent (DES) and associated outcomes in patients with pre-existing AF and first AMI undergoing percutaneous coronary intervention. Methods and results Patient records in this population-based study were retrospectively collected from the Taiwan National Health Insurance Research Database. Using propensity score matching (PSM), we used 1:2 ratio stratification into a DES group of 436 and a BMS group of 785 patients from 2007 to 2011. The mean follow-up of matched cohorts was 1.7 years. After PSM, DESs were associated with lower rates of cardiovascular death (7.8%, hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.39-0.86 and 10.1%, HR 0.64, 95% CI 0.45-0.90) and primary composite outcome (35.1%, HR 0.76, 95% CI 0.63-0.92 and 48.2%, HR 0.81, 95% CI 0.69-0.96) than BMSs within the first year and at the end of follow-up. Although the greatest benefit from DESs, irrespective of the first-and second-generation DESs, implantation was observed within the first year only, this benefit was not observed in patients with diabetes, chronic kidney disease, or dialysis.

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“…We defined CV deaths according to the criteria of the Standardised Definitions for End Point Events in Cardiovascular Trials, published by the Food and Drug Administration [20]. The definition of CV death has been published [5, 6]. Deaths were identified as NHI programme withdrawals [21].…”

Section: Methodsmentioning

confidence: 99%

Clinical outcomes of second-generation limus-eluting stents compared to paclitaxel-eluting stents for acute myocardial infarction with cardiogenic shock

et al. 2019

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Objective Whether the cardiovascular (CV) outcomes of second-generation limus-eluting stents (LESs) differ from those of paclitaxel-eluting stents (PESs) in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) is still unclear. Methods We used the Taiwan National Health Insurance Research Database to analyse data of 516 patients with AMI and CS diagnosed from January 2007 to December 2011. We used propensity score matching to adjust for the imbalance in covariate baseline values between these two groups. We evaluated clinical outcomes by comparing 197 subjects who used second-generation LESs to 319 matched subjects who used PESs. Results The risk of the primary composite outcomes (i.e., myocardial infarction, coronary revascularisation or CV death) was significantly lower in the second-generation LES group than in the PES group [37.3% vs. 51.8%; hazard ratio (HR), 0.73; 95% CI: 0.56–0.95] at the 12-month follow-up. The patients who received second-generation LESs had a lower risk of coronary revascularisation (HR 0.62; 95% CI: 0.41–0.93) than those who used PESs. However, the risks of myocardial infarction (HR 0.56; 95% CI: 0.26–1.24), ischemic stroke (HR 0.73; 95% CI: 0.23–2.35), or CV death (HR 0.90; 95% CI: 0.63–1.28) were not significantly different between the two groups. Conclusions Among patients with CS-complicating AMI, second-generation LES implantation significantly reduced the risk of coronary revascularisation and composite CV events compared to PES implantation at the 12-month follow-up.

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Clinical Outcomes of Drug-Eluting Stents vs. Bare-Metal Stents in Acute Myocardial Infarction Patients Under Dialysis　– A Nationwide Cohort Study –

Cited by 13 publications

References 32 publications

Comparison of Drug‐Eluting and Bare Metal Stents in Patients With Chronic Kidney Disease: An Updated Systematic Review and Meta‐Analysis

Comparison of Drug‐Eluting and Bare Metal Stents in Patients With Chronic Kidney Disease: An Updated Systematic Review and Meta‐Analysis

Drug-eluting versus bare-metal stents for first myocardial infarction in patients with atrial fibrillation: A nationwide population-based cohort study

Clinical outcomes of second-generation limus-eluting stents compared to paclitaxel-eluting stents for acute myocardial infarction with cardiogenic shock

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Clinical Outcomes of Drug-Eluting Stents vs. Bare-Metal Stents in Acute Myocardial Infarction Patients Under Dialysis – A Nationwide Cohort Study –

Cited by 13 publications

References 32 publications

Comparison of Drug‐Eluting and Bare Metal Stents in Patients With Chronic Kidney Disease: An Updated Systematic Review and Meta‐Analysis

Comparison of Drug‐Eluting and Bare Metal Stents in Patients With Chronic Kidney Disease: An Updated Systematic Review and Meta‐Analysis

Drug-eluting versus bare-metal stents for first myocardial infarction in patients with atrial fibrillation: A nationwide population-based cohort study

Clinical outcomes of second-generation limus-eluting stents compared to paclitaxel-eluting stents for acute myocardial infarction with cardiogenic shock

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Clinical Outcomes of Drug-Eluting Stents vs. Bare-Metal Stents in Acute Myocardial Infarction Patients Under Dialysis　– A Nationwide Cohort Study –