Impact of stent generation on 2-year clinical outcomes in ST-segment elevation myocardial infarction patients with multivessel disease who underwent culprit-only or multivessel percutaneous coronary intervention

Yong Hoon Kim, Ae Young Her, Myung Ho Jeong, Byeong Keuk Kim, Sung Jin Hong, Jung Sun Kim, Young Guk Ko, Donghoon Choi, Myeong Ki Hong, Yangsoo Jang

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Abstract

Background: Data concerning the impact of stent generation on long-term outcomes in ST-segment elevation myocardial infarction (STEMI) patients with multivessel disease (MVD) who underwent primary percutaneous coronary intervention (PCI) with culprit-only PCI (C-PCI) or multivessel PCI (M-PCI) are limited. Methods: A total of 7,266 patients were separated into the two groups, a C-PCI (n = 4,901) or M-PCI group (n = 2,365). The primary endpoint was the occurrence of major adverse cardiac events (MACE) defined as all-cause death, recurrent myocardial infarction, and any repeat revascularization. The secondary endpoint was the cumulative incidence of stent thrombosis (ST) at 2 years. Results: The cumulative incidence of MACE was significantly higher in the bare-metal stents (BMS) group than the first-generation (1G)-drug-eluting stents (DES) (C-PCI: adjusted hazard ratio [aHR], 1.940; 95% confidence interval [CI], 1.389–2.709; p <.001; M-PCI: aHR, 1.544; 95% CI, 1.099–2.074; p =.038), and the second-generation (2G)-DES group (C-PCI: aHR, 2.271; 95% CI, 1.657–3.114; p <.001; M-PCI: aHR, 2.999; 95% CI, 1.899–4.704; p <.001). In the M-PCI group, 1G-DES showed a higher incidence of MACE compared with 2G-DES (aHR, 1.639; 95% CI, 1.028–2.614; p =.004). The cumulative incidences of ST in the both groups were similar. Conclusion: The cumulative incidence of MACE was the lowest for 2G-DES, the highest for BMS, and intermediate for 1G-DES in the STEMI patients with MVD after C-PCI or M-PCI. However, cumulative incidence of ST in the two different reperfusion strategy groups was similar regardless of stent generation.

Original languageEnglish
Pages (from-to)E40-E55
JournalCatheterization and Cardiovascular Interventions
Volume95
Issue number2
DOIs
Publication statusPublished - 2020 Feb 1

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All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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