Effectiveness of Drug-Eluting Stents versus Bare-Metal Stents in Large Coronary Arteries in Patients with Acute Myocardial Infarction

Sim, Doo Sun; Jeong, Jin‐Ok; Ahn, Youngkeun; Kim, Young Jo; Chae, Shung Chull; Hong, Taek Jong; Seong, In Whan; Chae, Jei Keon; Kim, Chong Jin; Cho, Myeong Chan; Seung, Ki Bae; Park, Seung Jung

doi:10.3346/jkms.2011.26.4.521

Cited by 23 publications

(16 citation statements)

References 30 publications

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“…Lesion lengths and vessel reference diameter were visually evaluated by the operators [10-12]. And then, intravascular ultrasound (IVUS) was used to exactly estimate the target lesion and stent placement; 83.3% (50/60) of cases in group I and 69.3% (268/388) of cases in group II.…”

Section: Methodsmentioning

confidence: 99%

Two-year clinical outcomes in stable angina and acute coronary syndrome after percutaneous coronary intervention of left main coronary artery disease

Hyun

Jeong

Sim

et al. 2016

Korean J Intern Med

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Background/AimsThis study appraised the long term clinical outcomes of patients treated with percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) disease. There are limited data regarding long-term clinical outcomes after PCI for ULMCA disease.MethodsFrom 2001 to 2011, a total of 448 patients who underwent PCI for ULMCA disease and had 2-year clinical follow-up, were analyzed. The study patients were divided into two groups: group I (stable angina pectoris [SAP], n = 60, 48 men, 62 ± 10 years) and group II (acute coronary syndrome [ACS], n = 388, 291 men, 64 ± 10 years). We evaluated clinical and angiographic characteristics and major adverse cardiac events (MACE) during 2-year clinical follow-up.ResultsMean age of studied patients was 64 ± 10 years with 339 male patients. Average stent diameter was 3.6 ± 0.4 mm and stent length was 19.7 ± 6.3 mm. Stent implantation techniques and use of intravascular ultrasound guidance were not different between two groups. In-hospital mortality was 0% in group I and 7% in group II (p = 0.035). One-month mortality was 0% in group I and 7.7% in group II (p = 0.968). Two-year survival rate was 93% in the group I and 88.4% in the group II (p = 0.921). Predictive factors for 2-year MACE were hypertension, Killip class ≥ 3, and use of intra-aortic balloon pump by multivariate analysis.ConclusionsAlthough in-hospital mortality rate was higher in ACS than in SAP, clinical outcomes during 2-year clinical follow-up were similar between SAP and ACS after PCI of ULMCA.

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Section: Methodsmentioning

confidence: 99%

Two-year clinical outcomes in stable angina and acute coronary syndrome after percutaneous coronary intervention of left main coronary artery disease

Hyun

Jeong

Sim

et al. 2016

Korean J Intern Med

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“…Sim et al compared clinical outcomes of BMS vs DES in large coronary arteries (≥3.5 mm) with lesions <25 mm in 985 AMI patients undergoing PCI (38). During 1 yr follow-up, the rates of target lesion revascularization (TLR) and target vessel revascularization (TVR) were lower in the DES group (2.5% vs 5.9%, P =0.032 and 3.1% vs 5.9%, P =0.041) than BMS group with no difference in the rate of death or MI and MACEs, suggesting usefulness of DES in large vessels in AMI patients over BMS without compromising overall safety.…”

Section: Percutaneous Coronary Interventionmentioning

confidence: 99%

New Horizons of Acute Myocardial Infarction: From the Korea Acute Myocardial Infarction Registry

et al. 2013

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As the first nationwide Korean prospective multicenter data collection registry, the Korea Acute Myocardial Infarction Registry (KAMIR) launched in November 2005. Through a number of innovative approaches, KAMIR suggested new horizons about acute myocardial infarction (AMI) which contains unique features of Asian patients from baseline characteristics to treatment strategy. Obesity paradox was existed in Korean AMI patients, whereas no gender differences among them. KAMIR score suggested new risk stratifying method with increased convenience and an enhanced accuracy for the prediction of adverse outcomes. Standard loading dose of clopidogrel was enough for Asian AMI patients. Triple antiplatelet therapy with aspirin, clopidogrel and cilostazol could improve clinical outcomes than dual antiplatelet therapy with aspirin and clopidogrel. Statin improved clinical outcomes even in AMI patients with very low LDL-C levels. The rate of percutaneous coronary intervention was higher and door-to-balloon time was shorter than the previous reports. Zotarolimus eluting stents as the 2nd generation drug-eluting stent (DES) was not superior to the 1st generation DES, in contrast to the western AMI studies. KAMIR made a cornerstone in the study of Korean AMI and expected to be new standards of care for AMI with the renewal of KAMIR design to overcome its pitfalls.

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“…Many studies found that the superiority of DES versus BMS decreased with increasing vessel diameter, while it increased with increasing lesion length and complexity, making the use of BMS strongly discouraged in particular in the setting of BiF and ULM. [14][15][16][17][18][19][20] Independently from site of lesions and of strategy for BiF, PF-BESs performed similar to ultrathin stents. The populations of the two registries presented also different clinical characteristics, with higher incidence of unfavorable features for PF-BES registry (older patients, higher incidence of female gender, diabetes mellitus, etc.).…”

Section: Pf-bess Have Till Now Shown Good Results For Mid and Long-termmentioning

confidence: 84%

“…After 12 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) months, rates of MACE were similar (9 vs. 8%, p = .56; see Figure 2 and Appendix web only table 7 and figure 1) without difference in TVR and TLR (3.9 vs. 2.8% and 3.0 vs. 1.7% p = . 19).…”

Section: Kind Of Ultrathin Stents Were Reported Inmentioning

confidence: 89%

Safety and efficacy of polymer‐free biolimus‐eluting stents versus ultrathin stents in unprotected left main or coronary bifurcation: A propensity score analysis from the RAIN and CHANCE registries

D’Ascenzo

Gaido

Bernardi

et al. 2019

Cathet Cardio Intervent

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Objectives Evaluate safety and efficacy of polymer‐free biolimus‐eluting stents (PF‐BESs) versus ultrathin stents in unprotected left main (ULM) or bifurcation. Background PF‐BESs due to reduced length of dual antiplatelet therapy (DAPT) are increasingly used. However, there are limited data about safety and efficacy for ULM or bifurcation. Methods We selected all‐patients treated for ULM or bifurcation from two multicenter real life registries (RAIN [NCT03544294] evaluating ultrathin stents, CHANCE [NCT03622203] appraising PF‐BES). After propensity score with matching, the primary endpoint was major adverse cardiac events (MACE; a composite of all‐cause death, myocardial infarction, target lesion revascularization [TLR], and stent thrombosis [ST]), while its components along with target vessel revascularization (TVR) secondary endpoints. Results Three thousand and three patients treated with ultrathin stents and 446 with PF‐BESs, resulting respectively in 562 and 281 after propensity score with matching (33 and 22%, respectively, with ULM disease). After 12 (8–20) months, rates of MACE were similar (9 vs. 8%, p = 0.56) without difference in TLR and ST (3.0 vs. 1.7%, p = .19 and 1.8 vs. 1.1%, p = .42). These results were consistent for ULM group (3 vs. 1.7% and 1.8 vs. 1.1%, p = .49 and .76), for non‐ULM group (2.1 vs. 3.4%, p = .56 and 1.2 vs. 1.7%, p = .78) and for two‐stent strategy (8.7 vs. 4.5% and 4.3 vs. 3.2%, p = .75 and .91). Among patients treated with 1 month of DAPT in both groups, those with ultrathin stents experienced higher rates of MACE related to all‐cause death (22 vs. 12%, p = .04) with higher although not significant rates of ST (3 vs. 0%, p = .45). Conclusions PF‐BES implanted on ULM or BiF offered freedom from TLR and ST comparable to ultrathin stents. PF‐BESs patients assuming DAPT for 1 month experienced a lower despite not significant incidence of ST.

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Effectiveness of Drug-Eluting Stents versus Bare-Metal Stents in Large Coronary Arteries in Patients with Acute Myocardial Infarction

Cited by 23 publications

References 30 publications

Two-year clinical outcomes in stable angina and acute coronary syndrome after percutaneous coronary intervention of left main coronary artery disease

Two-year clinical outcomes in stable angina and acute coronary syndrome after percutaneous coronary intervention of left main coronary artery disease

New Horizons of Acute Myocardial Infarction: From the Korea Acute Myocardial Infarction Registry

Safety and efficacy of polymer‐free biolimus‐eluting stents versus ultrathin stents in unprotected left main or coronary bifurcation: A propensity score analysis from the RAIN and CHANCE registries

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