Clinical outcomes of everolimus- and zotarolimus-eluting stents in patients with acute myocardial infarction for small coronary artery disease.

Abstract

BACKGROUND AND PURPOSE:

There were limited data about comparison of zotarolimus-eluting stents (ZES) and everolimus-eluting stents (EES) in patients with small coronary artery disease (CAD), especially in patients with acute myocardial infarction (AMI). The objective of this study was to compare the clinical outcomes of ZES and EES in patients with AMI for small CAD.

METHODS AND SUBJECTS:

A total 1565 AMI patients treated with Endeavor-ZES (n=651) (Medtronic CardioVascular, Santa Rosa, CA, USA) or Xience V/Promus-EES (n=914) (Abbott Vascular, Temecula, CA/Boston Scientific, Natick, MA, USA) for small CAD (stent diameter ≤ 2.75 mm) in KAMIR (Korea Acute Myocardial Infarction Registry) were enrolled. After propensity score matching to adjust for baseline clinical and angiographic characteristics, we compared a total 1302 patients (651 ZES and 651 EES) about major adverse cardiac events (MACE) at 1-year. Subgroup analysis about 1-year clinical outcomes was undertaken in patients who were discharged alive.

RESULTS:

Baseline clinical and angiographic characteristics were similar between the two groups after propensity score matching. Total MACE did not differ between the two groups before (9.8% vs. 8.2%, p=0.265) and after (9.8% vs. 9.4%, p=0.778) propensity score matching. The EES group showed lower rate of 1-year cardiac death (5.4% vs. 3.3%, p=0.041), target lesion failure (TLF; 6.9% vs. 4.3%, p=0.022), and stent thrombosis (1.4% vs. 0.4%, p=0.042) compared with the ZES group. However, there were no differences in 1-year cardiac death, TLF, and stent thrombosis in propensity score matched populations. Other various 1-year clinical outcomes showed no difference between the two groups. Subgroup analysis in patients who were discharged alive showed similar outcomes between the two groups at 1-year follow-up.

CONCLUSION:

In-this propensity score matched analysis, EES and ZES showed no significant difference in clinical outcomes at 1-year follow-up in patients with AMI for small CAD.

• Authors: Sang Cheol Cho, Myung Ho Jeong, Wan Kim, Youngkeun Ahn, Young Joon Hong, Young Jo Kim, Chong Jin Kim, Myeong Chan Cho, Kyoo Rok Han, Hyo Soo Kim, Korea Acute Myocardial Infarction Registry Investigators
• Journal: Journal of cardiology (J Cardiol) Vol. 63 Issue 6 Pg. 409-17 (Jun 2014) ISSN: 1876-4738 [Electronic] Netherlands
• PMID: 24314902 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013. Published by Elsevier Ltd.

Chemical References

• Everolimus
• zotarolimus
• Sirolimus

Topics

• Aged
• Aged, 80 and over
• Coronary Angiography
• Coronary Artery Disease (diagnostic imaging, pathology, therapy)
• Coronary Vessels (pathology)
• Drug-Eluting Stents
• Everolimus
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Myocardial Infarction (diagnostic imaging, pathology, therapy)
• Propensity Score
• Sirolimus (administration & dosage, analogs & derivatives)
• Time Factors
• Treatment Outcome