Paclitaxel- Versus Sirolimus-Eluting Stents for Treatment of ST-Segment Elevation Myocardial Infarction With Analyses for Diabetic and Nondiabetic Subpopulation

被引：19

作者：

Cho, Youngjin ^{[1
]}

Yang, Han-Mo ^{[1
]}

Park, Kyung-Woo ^{[1
]}

Chung, Woo-Young ^{[2
]}

Choi, Dong-Joo ^{[2
]}

Seo, Won-Woo ^{[1
]}

Jeong, Kyoung-Tae ^{[3
]}

Chae, Sung-Chul ^{[4
]}

Lee, Myoung-Yong ^{[5
]}

Hur, Seung-Ho ^{[6
]}

Chae, Jei-Keon ^{[7
]}

Seong, In-Whan ^{[8
]}

Yoon, Jung-Han ^{[9
]}

Oh, Suk-Kyu ^{[10
]}

Kim, Doo-Il ^{[11
]}

Park, Keum-Soo ^{[12
]}

Rha, Seung-Woon ^{[13
]}

Jang, Yang-Soo ^{[14
]}

Bae, Jang-Ho ^{[15
]}

Hong, Taeg-Jong ^{[16
]}

Cho, Myeong-Chan ^{[17
]}

Kim, Young-Jo ^{[18
]}

Jeong, Myung-Ho ^{[19
]}

Kim, Min-Jung ^{[20
]}

Park, Sue K. ^{[20
]}

Chae, In-Ho ^{[2
]}

Kim, Hyo-Soo ^{[1
]}

机构：

[1] Seoul Natl Univ Hosp, Ctr Cardiovasc, Seoul 110744, South Korea

[2] Seoul Natl Univ, Bundang Hosp, Ctr Cardiovasc, Div Cardiol, Songnam 464707, Gyeonggi Do, South Korea

[3] Eulji Gen Hosp, Seoul, South Korea

[4] Kyungpook Natl Univ Hosp, Taegu, South Korea

[5] Dankook Univ Hosp, Cheonan, South Korea

[6] Keimyung Univ, Dongsan Hosp, Taegu, South Korea

[7] Chonbuk Natl Univ Hosp, Jeonju, South Korea

[8] Chungnam Natl Univ Hosp, Taejon, South Korea

[9] Wonju Christian Hosp, Wonju, South Korea

[10] Wonkwang Univ Hosp, Iksan, South Korea

[11] Busan Paik Hosp, Pusan, South Korea

[12] Inha Univ Hosp, Inchon, South Korea

[13] Korea Univ, Guro Hosp, Seoul, South Korea

[14] Yonsei Univ, Severance Hosp, Seoul 120749, South Korea

[15] Konyang Univ Hosp, Taejon, South Korea

[16] Busan Natl Univ Hosp, Pusan, South Korea

[17] Choong Buk Natl Univ, Cheongju, South Korea

[18] Young Nam Univ Hosp, Taegu, South Korea

[19] Chonnam Natl Univ Hosp, Kwangju, South Korea

[20] Seoul Natl Univ, Coll Med, Dept Prevent Med, Med Res Collaborating Ctr, Seoul, South Korea

来源：

JACC-CARDIOVASCULAR INTERVENTIONS | 2010年 / 3卷 / 05期

关键词：

diabetes mellitus; myocardial infarction; stents; BARE-METAL STENTS; PERCUTANEOUS CORONARY INTERVENTION; PROPENSITY SCORE; RANDOMIZED-TRIAL; UNCOATED STENTS; ARTERY-DISEASE; OUTCOMES; MUSCLE; MELLITUS; REVASCULARIZATION;

D O I：

10.1016/j.jcin.2010.02.011

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives The aim of this study was to determine which drug-eluting stent (DES) is preferable for the treatment of ST-segment elevation myocardial infarction (STEMI) and to elucidate the impact of diabetes mellitus on the outcome of each DES. Background Recent studies have shown the benefit of DES in patients with STEMI. Diabetes mellitus might differentially affect outcomes of each DES. Methods We analyzed the large-scale, prospective, observational KAMIR (Korea Acute Myocardial Infarction Registry) study, which enrolled 4,416 STEMI patients (26% with diabetes) treated with paclitaxel-eluting stent (PES) or sirolimus-eluting stent (SES). Primary outcome was major adverse cardiac event (MACE), defined as a composite of mortality, nonfatal myocardial infarction, and target lesion revascularization (TLR). Results In the overall population, the MACE rate at 1 year was significantly higher in the PES than the SES group (11.6% vs. 8.6%, p = 0.014), which was mainly due to increased TLR (3.7% vs. 1.8%, p < 0.001). In the diabetic subgroup, however, the MACE rate was not significantly different between PES and SES (14.5% vs. 12.3%, p = 0.217), in contrast to the nondiabetic subgroup, where PES was inferior to SES as in the overall population. Matching by propensity-score did not significantly alter these results. For TLR, there was interaction between the type of stents and diabetes mellitus (unadjusted: p = 0.052; after propensity-score matching: p = 0.035). Conclusions The PES was inferior to the SES in the overall population, with regard to the occurrence of MACE and TLR. However, subgroup analysis for diabetic subjects showed no differences in clinical outcomes between PES and SES. These results suggest that diabetes differentially affects the outcome of first-generation DES. (J Am Coll Cardiol Intv 2010;3:498-506) (C) 2010 by the American College of Cardiology Foundation

引用

页码：498 / 506

页数：9

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