Comparison of Outcomes Between Zotarolimus- and Sirolimus-Eluting Stents in Patients With ST-Segment Elevation Acute Myocardial Infarction

Hyun Kuk Kim, Myung Ho Jeong, Young Keun Ahn, Jong Hyun Kim, Shung Chull Chae, Young Jo Kim, Seung Ho Hur, In Whan Seong, Taek Jong Hong, Dong Hoon Choi, Myeong Chan Cho, Chong Jin Kim, Ki Bae Seung, Wook Sung Chung, Yang Soo Jang, Seung Woon Rha, Jang Ho Bae, Jeong Gwan Cho, Seung Jung Park

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18 Citations (Scopus)

Abstract

Zotarolimus-eluting stents (ZESs) demonstrated greater in-segment late luminal loss and in-segment binary restenosis rates compared to sirolimus-eluting stents (SESs) in several studies. However, no data are available in direct comparison between the clinical outcomes of the 2 stents in unselected patients with ST-segment elevation acute myocardial infarction (STEMI). The aim of the present study was to compare the clinical outcomes of ZESs and SESs in real-world patients with STEMI. A total of 873 patients with STEMI (306 patients in the ZES group and 567 patients in the SES group) were enrolled in a nationwide prospective Korea Acute Myocardial Infarction Registry (KAMIR) from January 2007 to January 2008. The primary end points were major adverse cardiac events, a composite of all causes of death, myocardial infarction, and target lesion revascularization during a 12-month clinical follow-up. During 1 year of follow-up, the primary end points occurred in 140 patients (16.0%). The use of glycoprotein IIb/IIIa inhibitors and the occurrence of multivessel disease were more common in the SES group. The SES group had a significantly lower incidence of major adverse cardiac events (hazard ratio [HR] 1.52, 95% confidence interval [CI] 1.07 to 2.16, p = 0.02), target lesion revascularization (HR 2.16, 95% CI 1.01 to 4.59, p = 0.046), and target vessel revascularization (HR 2.24, 95% CI 1.18 to 4.24, p = 0.013). However, no significant differences were found in death or myocardial infarction (HR 1.37, 95% CI 0.91 to 2.05, p = 0.129). In conclusion, SESs provided superior angiographic outcomes, translating into better clinical outcomes and negating any change in STEMI patient safety profiles compared to ZESs.

Original languageEnglish
Pages (from-to)813-818
Number of pages6
JournalAmerican Journal of Cardiology
Volume105
Issue number6
DOIs
Publication statusPublished - 2010 Mar 15

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Kim, H. K., Jeong, M. H., Ahn, Y. K., Kim, J. H., Chae, S. C., Kim, Y. J., Hur, S. H., Seong, I. W., Hong, T. J., Choi, D. H., Cho, M. C., Kim, C. J., Seung, K. B., Chung, W. S., Jang, Y. S., Rha, S. W., Bae, J. H., Cho, J. G., & Park, S. J. (2010). Comparison of Outcomes Between Zotarolimus- and Sirolimus-Eluting Stents in Patients With ST-Segment Elevation Acute Myocardial Infarction. American Journal of Cardiology, 105(6), 813-818. https://doi.org/10.1016/j.amjcard.2009.11.009