Coronary Stents in Patients with ST-Elevation Myocardial Infarction and Chronic Kidney Disease Undergoing Primary Percutaneous Coronary Intervention
Korean Circulation Journal
;
: 830-838, 2012.
Artículo
en Inglés
| WPRIM
| ID: wpr-17965
ABSTRACT
BACKGROUND AND OBJECTIVES:
Chronic kidney disease (CKD) is associated with poor outcomes after percutaneous coronary intervention (PCI). We sought to compare different coronary stents used during primary PCI in patients with ST-elevation myocardial infarction (STEMI) and CKD. SUBJECTS ANDMETHODS:
We selected 2408 consecutive STEMI patients with CKD (estimated glomerular filtration rate <60 mL/min/1.73 m2) undergoing primary PCI and divided them into 5 groups based on the type of stent implanted 1) bare metal stent (BMS), 2) paclitaxel-eluting stent (PES), 3) sirolimus-eluting stent (SES), 4) zotarolimus-eluting stent (ZES), or 5) everolimus-eluting stent (EES). The study endpoint was the number of major adverse cardiac events (MACE) at 12 months.RESULTS:
There was no significant difference in the incidence of 12-month myocardial infarction, target lesion revascularization, or target vessel revascularization between stent groups; however, the overall rate of repeat revascularization differed significantly between groups. All-cause death differed significantly among the groups. The incidence of 12-month MACE in BMS, PES, SES, ZES, and EES was 8.3%, 9.8%, 8.6%, 5.5%, and 2.6%, respectively (p<0.001). Kaplan-Meier analysis did not show a significant differences in 12-month MACE-free survival among the groups (log-rank p=0.076). This finding remained the same after adjusting for multiple confounders (p=0.147).CONCLUSION:
Any of the 5 stents can be used to treat STEMI patients with CKD undergoing primary PCI; all have similar risk of 12-month MACE. This result is hypothesis-generating and warrants further evaluation with a long-term randomized study.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Stents
/
Incidencia
/
Angioplastia
/
Insuficiencia Renal Crónica
/
Estimación de Kaplan-Meier
/
Intervención Coronaria Percutánea
/
Tasa de Filtración Glomerular
/
Glicosaminoglicanos
/
Fallo Renal Crónico
/
Infarto del Miocardio
Tipo de estudio:
Ensayo Clínico Controlado
/
Estudio de incidencia
/
Estudio pronóstico
Límite:
Humanos
Idioma:
Inglés
Revista:
Korean Circulation Journal
Año:
2012
Tipo del documento:
Artículo
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