Abstract 14872: Long-term Clinical Outcomes After Everolimus-eluting Stent Implantation in Patients With Acute Myocardial Infarction in Comparison With Sirolimus-eluting Stent
Introduction: Everolimus-eluting stent (EES) reduces the risk of restenosis after coronary angioplasty; however, few real-world data have been reported on the long-term benefit and safety of EES implantation in patients with acute myocardial infarction (AMI).
Purpose: To evaluate long-term clinical outcomes after EES implantation in AMI patients undergoing primary angioplasty in comparison with those after sirolimus-eluting stent (SES) implantation in real-world settings.
Methods: We analysed AMI patients undergoing primary angioplasty with implantation using EES (336 patients, EES group) and SES (284 patients, SES group) between 2004 and 2012. Angiographic follow-up was scheduled 8 months and 20 months after procedure. We retrospectively assessed the clinical outcomes including all-cause death, cardiac death, target lesion revascularisation (TLR), ischemia-driven TLR, target vessel revascularisation, definite stent thrombosis, and nonfatal myocardial infarction. The Academic Research Consortium definition of definite stent thrombosis was used.
Results: The 3-year clinical follow-up was completed in 355 patients (98.1%) in the EES group and 289 patients (98.3%) in the SES group. Between the EES and SES groups, significant differences were found in the 3-year cumulative rates of TLR (7.1% vs. 13.1%, p < 0.01), ischemia-driven TLR (2.1% vs. 4.5%, p = 0.04), and target vessel revascularisation (10.3% vs. 18.2%, p < 0.01), whereas no significant differences were noted in those of all-cause death (13.7% vs. 17.2%, p = 0.45), cardiac death (5.7% vs. 5.9%, p = 0.79), definite stent thrombosis (0.2% vs. 0.6%, p = 0.17), and nonfatal myocardial infarction (0.9% vs. 1.4%, p = 0.28). After multivariate adjustment, the risk of TLR was lower in the EES group than in the SES group (odds ratio, 0.37; 95% confidence interval, 0.22 to 0.64; p < 0.001).
Conclusion: Long-term clinical outcomes of AMI patients undergoing primary angioplasty suggest that EES implantation improves the cumulative rate of TLR compared with SES implantation in real-world settings.
Author Disclosures: R. Hata: None. K. Kadota: None. H. Yusuke: None. S. Otsuru: None. S. Habara: None. T. Tada: None. H. Tanaka: None. Y. Fuku: None. T. Goto: None.
- © 2016 by American Heart Association, Inc.