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

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Author(s)
Keum-Soo ParkSeung-Woon RhaYang-Soo JangJang-Ho BaeTaeg-Jong HongMyeong-Chan ChoYoung-Jo KimMyung-Ho JeongMin-Jung KimSue K. ParkIn-Ho ChaeHyo-Soo KimKyoung-Tae JeongSung-Chul ChaeMyoung-Yong LeeSeung-Ho HurJei-Keon ChaeIn-Whan SeongJung-Han YoonSuk-Kyu OhDoo-Il KimYoungjin ChoHan-Mo YangKyung-Woo ParkWoo-Young ChungDong-Joo ChoiWon-Woo Seo
Keimyung Author(s)
Hur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
JACC: Cardiovascular Interventions
Issued Date
2010
Volume
3
Issue
5
Keyword
diabetes mellitusmyocardial infarctionstents
Abstract
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.
Keimyung Author(s)(Kor)
허승호
Publisher
School of Medicine
Citation
Keum-Soo Park et al. (2010). Paclitaxel- Versus Sirolimus-Eluting Stents for Treatment of ST-Segment Elevation Myocardial Infarction With Analyses for Diabetic and Nondiabetic Subpopulation. JACC: Cardiovascular Interventions, 3(5), 498–506. doi: 10.1016/j.jcin.2010.02.011
Type
Article
ISSN
1936-8798
DOI
10.1016/j.jcin.2010.02.011
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33909
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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