Comparison of drug-eluting stents with bare metal stents implantation for the treatment of acute ST-elevation myocardial infarction： 2-year clinical outcomes from single-center registry  

作　　者：LI Yi HAN Ya-ling ZHANG Quan-yu GUAN Shao-yi WANG Xiao-zeng JING Quan-min MA Ying-yan WANG Geng WANG Bin DENG Jie 

机构地区：[1]Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China [2]Department of Cardiology, Institute of Cardiovascular Research of People's Liberation Army, Shenyang Northern Hospital, Shenyang,Liaoning 110840, China

出　　处：《Chinese Medical Journal》2011年第6期825-830,共6页中华医学杂志（英文版）

基　　金：This study was supported by grants from the National Natural Science Foundation of China （NSFC） （No. 30800465） and Science and Technical Foundation of Liaoning Province （No. 20092090）.

摘　　要：Background Some larger scale, randomized studies have demonstrated the superiority of drug-eluting stents （DES） over bare metal stents （BMS） for the treatment of acute myocardial infarction （AMI）. This study aimed to investigate the impact of DES, in comparison with BMS, on the 2-year clinical outcomes in patients with ST-elevation myocardial infarction （STEMI）.Methods From January 2002 to December 2008, a total of 1301 consecutive STEMI patients treated with coronary stenting in Shenyang Northern Hospital were prospectively registered. Patients received BMS （n=868） or DES （n=435） implantation in the infarction related artery according to physician＇s discretion. A propensity score analysis was performed and two well matched subgroups were selected （BMS, n=288; DES, n=288） to evaluate the 2-year clinical outcomes. The primary outcome was the occurrence of major adverse cardiac events （MACE）, which was defined as a composite of all-cause death, myocardial infarction （MI）, or target vessel revascularization （TVR）.Results Survival salvage analysis showed that 2-year cumulative hazards were not significantly different between the two groups with respect to TVR （2.8% vs. 3.1%, log-rank P=0.780）, stent thrombosis （1.7% vs. 4.2%, log-rank P=0.079） and MACE （8% vs. 10.8%, log-rank P=0.236）. Multivariate analysis showed that DES was an independent protective factor of MI （HR： 0.211, 95% CI： 0.049 to 0.908） and stent thrombosis （HR： 0.327, 95% CI： 0.107 to 0.994）.Conclusion DES was associated with similar 2-year clinical outcomes to those of BMS for the treatment of STEMI in daily practice.Background Some larger scale, randomized studies have demonstrated the superiority of drug-eluting stents （DES） over bare metal stents （BMS） for the treatment of acute myocardial infarction （AMI）. This study aimed to investigate the impact of DES, in comparison with BMS, on the 2-year clinical outcomes in patients with ST-elevation myocardial infarction （STEMI）.Methods From January 2002 to December 2008, a total of 1301 consecutive STEMI patients treated with coronary stenting in Shenyang Northern Hospital were prospectively registered. Patients received BMS （n=868） or DES （n=435） implantation in the infarction related artery according to physician＇s discretion. A propensity score analysis was performed and two well matched subgroups were selected （BMS, n=288; DES, n=288） to evaluate the 2-year clinical outcomes. The primary outcome was the occurrence of major adverse cardiac events （MACE）, which was defined as a composite of all-cause death, myocardial infarction （MI）, or target vessel revascularization （TVR）.Results Survival salvage analysis showed that 2-year cumulative hazards were not significantly different between the two groups with respect to TVR （2.8% vs. 3.1%, log-rank P=0.780）, stent thrombosis （1.7% vs. 4.2%, log-rank P=0.079） and MACE （8% vs. 10.8%, log-rank P=0.236）. Multivariate analysis showed that DES was an independent protective factor of MI （HR： 0.211, 95% CI： 0.049 to 0.908） and stent thrombosis （HR： 0.327, 95% CI： 0.107 to 0.994）.Conclusion DES was associated with similar 2-year clinical outcomes to those of BMS for the treatment of STEMI in daily practice.

关 键 词：coronary heart disease drug-eluting stent bare metal stent RESTENOSIS 

分 类 号：TP18[自动化与计算机技术—控制理论与控制工程] R542.22[自动化与计算机技术—控制科学与工程]