Comparison of drug-eluting stents in acute myocardial infarction patients with chronic kidney disease

Daisuke Hachinohe, Myung Ho Jeong, Shigeru Saito, Min Chol Kim, Kyung Hoon Cho, Khurshid Ahmed, Seung Hwan Hwang, Min Goo Lee, Doo Sun Sim, Keun Ho Park, Ju Han Kim, Young Joon Hong, Youngkeun Ahn, Jung Chaee Kang, Jong Hyun Kim, Shung Chull Chae, Young Jo Kim, Seung Ho Hur, In Whan Seong, Taek Jong HongDonghoon Choi, Myeong Chan Cho, Chong Jin Kim, Ki Bae Seung, Wook Sung Chung, Yang Soo Jang, Seung Woon Rha, Jang Ho Bae, Seung Jung Park

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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.

Original languageEnglish
Pages (from-to)397-406
Number of pages10
JournalKorean Journal of Internal Medicine
Volume27
Issue number4
DOIs
Publication statusPublished - 2012 Dec 1

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All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Hachinohe, D., Jeong, M. H., Saito, S., Kim, M. C., Cho, K. H., Ahmed, K., Hwang, S. H., Lee, M. G., Sim, D. S., Park, K. H., Kim, J. H., Hong, Y. J., Ahn, Y., Kang, J. C., Kim, J. H., Chae, S. C., Kim, Y. J., Hur, S. H., Seong, I. W., ... Park, S. J. (2012). Comparison of drug-eluting stents in acute myocardial infarction patients with chronic kidney disease. Korean Journal of Internal Medicine, 27(4), 397-406. https://doi.org/10.3904/kjim.2012.27.4.397