Everolimus-eluting stents show no stent thrombosis with similar one year outcomes compared with 1st and 2nd generation drug-eluting stents for the treatment of ST-segment elevation myocardial infarction

초록

Background: There were no published data regarding the clinical efficacy and safety of second generation drug-eluting stent (everolimus-eluting stent, EES) following primary percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI). We evaluated the one-year outcome of everolimus-eluting stent versus to 1st generation (sirolimus-eluting stent, SES and paclitaxel-eluting stent, PES)and 2nd generation (zotarolimus-eluting stent) drug-eluting stents(DES) for the treatment of STEMI. Methods: A prospective, open-labeled, multi-center cohort has been performed at 4centers in Korea. All patients will be clinically followed-up for two years. The primary endpoint was major adverse cardiac event (MACE): the composite of cardiac death(CD), recurrent MI and ischemia-driven target vessel revascularization (TVR) at 1year. Stent thromboses (ST) by ARC definition were analyzed. Results: Total 797 patients (EES=197, ZES=203, SES=203, PES=194) who were completed more than one year were analyzed. One-year MACE were 2.0%, 5.9%,3.4% and 5.7% in EES-, ZES-, SES- and PES-group, respectively (p=ns). Cardiacdeath was 1.0%, 2.5%, 1.5% and 1.0% in EES-, ZES-, SES- and PES-group,respectively (p=ns). ST was 0%, 2.0%, 2.0% and 2.0% in EES-, ZES-, SES- and PES-group, respectively (p=ns). Conclusion: Campared to 1st and 2nd generation DES (SES and PES, ZES), EES showed similar one-year clinical outcomes in terms of MACE in patients with STEMI following primary PCI and no stent thrombosis.