The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Comparison of Drug-Eluting Stents in Acute Myocardial Infarction Patients with Chronic Kidney Disease

  • Hachinohe, Daisuke (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Jeong, Myung Ho (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Saito, Shigeru (Department of Internal Medicine, Sapporo Higashi Tokushukai Hospital) ;
  • Kim, Min Chol (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Cho, Kyung Hoon (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Ahmed, Khurshid (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Hwang, Seung Hwan (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Lee, Min Goo (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Sim, Doo Sun (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Park, Keun-Ho (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Kim, Ju Han (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Hong, Young Joon (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Ahn, Youngkeun (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Kang, Jung Chaee (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Kim, Jong Hyun (Department of Internal Medicine, Pusan Hanseo Hospital) ;
  • Chae, Shung Chull (Department of Internal Medicine, Kyungpook National University Hospital) ;
  • Kim, Young Jo (Department of Internal Medicine, Yeungnam University Medical Center) ;
  • Hur, Seung Ho (Department of Internal Medicine, Keimyung University Dongsan Medical Center) ;
  • Seong, In Whan (Department of Internal Medicine, Chungnam National University Hospital) ;
  • Hong, Taek Jong (Department of Internal Medicine, Pusan National University Hospital) ;
  • Choi, Donghoon (Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Cho, Myeong Chan (Department of Internal Medicine, Chungbuk National University Hospital) ;
  • Kim, Chong Jin (Department of Internal Medicine, Kyung Hee University Medical Center) ;
  • Seung, Ki Bae (Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Chung, Wook Sung (Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Jang, Yang Soo (Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Rha, Seung Woon (Department of Internal Medicine, Korea University Guro Hospital) ;
  • Bae, Jang Ho (Department of Internal Medicine, Konyang University Hospital) ;
  • Park, Seung Jung (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Korea Acute Myocardial Infarction Registry Investigators, Korea Acute Myocardial Infarction Registry Investigators (Korea Acute Myocardial Infarction Registry Investigators)
  • Published : 2012.12.01
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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 < $60mL/min/1.73m^2$ 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.

Keywords

References

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