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Comparison of Drug-Eluting Stents in Acute Myocardial Infarction Patients with Chronic Kidney Disease

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Affiliated Author(s)
허승호
Alternative Author(s)
Hur, Seung Ho
Journal Title
Korean Journal of Internal Medicine
ISSN
1226-3303
Issued Date
2012
Keyword
Myocardial infarctionRenal insufficiencyChronicStents
Abstract
Background/Aims: To determine which drug-eluting stents are more effective in acute myocardial infarction (MI)
patients with chronic kidney disease (CKD). Methods: This study included a total of 3,566 acute MI survivors with CKD from the Korea Acute Myocardial Infarction Registry who were treated with stenting and followed up for 12 months: 1,845 patients who received sirolimus-eluting
stents (SES), 1,356 who received paclitaxel-eluting stents (PES), and 365 who received zotarolimus-eluting stents (ZES). CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m2 calculated by the modification of diet in renal disease method. Results: At the 12-month follow-up, patients receiving ZES demonstrated a higher incidence (14.8%) of major adverse cardiac events (MACEs) compared to those receiving SES (10.1%) and PES (12%, p = 0.019). The ZES patients also had a higher incidence (3.9%) of target lesion revascularization (TLR) compared to those receiving SES (1.5%) and PES (2.4%, p = 0.011). After adjusting for confounding factors, ZES was associated with a higher incidence of MACE and TLR than SES (adjusted hazard ratio [HR], 0.623; 95% confidence interval [CI], 0.442 to 0.879; p = 0.007; adjusted
HR, 0.350; 95% CI, 0.165 to 0.743; p = 0.006, respectively), and with a higher rate of TLR than PES (adjusted HR, 0.471; 95% CI, 0.223 to 0.997; p = 0.049). Conclusions: Our findings suggest that ZES is less effective than SES and PES in terms of 12-month TLR, and has a higher incidence of MACE due to a higher TLR rate compared with SES, in acute MI patients with CKD.
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine
Citation
Daisuke Hachinohe et al. (2012). Comparison of Drug-Eluting Stents in Acute Myocardial Infarction Patients with Chronic Kidney Disease. Korean Journal of Internal Medicine, 27(4), 397–406. doi: 10.3904/kjim.2012.27.4.397
Type
Article
ISSN
1226-3303
DOI
10.3904/kjim.2012.27.4.397
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/36092
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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