Key result
New-generation drug-eluting stent implantation was associated with a lower 5-year risk of hospitalization for heart failure compared to bare-metal stents in patients with STEMI (SHR 0.82).
Why the study?
It remained unknown whether new-generation drug-eluting stents reduce hospitalization for heart failure in STEMI patients receiving an undefined duration of DAPT.
Does new-generation drug-eluting stent implantation reduce the risk of hospitalization for heart failure in patients with STEMI receiving an undefined duration of DAPT compared to bare-metal stents?
Cohort (n=13,662)
Does new-generation drug-eluting stent implantation reduce the risk of hospitalization for heart failure in patients with STEMI receiving an undefined duration of DAPT compared to bare-metal stents?
In a real-world STEMI population, the use of new-generation drug-eluting stents was associated with a significantly lower 5-year risk of heart failure hospitalization compared to bare-metal stents.
Answers are grounded in this paper and cite their sources.
NG-DES was associated with lower 5-year HF hospitalization in STEMI; leaves open whether RCTs confirm benefit or alter stent choice.
It remains unknown as to whether the use of new-generation drug-eluting stent (NG-DES) in patients with ST-elevation myocardial infarction (STEMI) who receive an undefined duration of dual antiplatelet therapy (DAPT) reduces the risk of hospitalization for heart failure (HHF). In this population-based retrospective cohort study, we applied propensity score matching to select 6831 pairs of patients with STEMI who had similar baseline characteristics and received either NG-DES or bare-metal stent (BMS) implantation between 1 January 2007 and 31 December 2016. The risk of stent-associated HHF was evaluated, wherein death was considered a competing risk. Rates of cumulative incidence competing risk for HHF at the 1, 2, 3, 4, and 5 year follow-up were lower in the NG-DES group (3.79%, 5.21%, 6.15%, 7.01%, and 8.29%, respectively) than in the BMS group (4.51%, 6.21%, 7.32%, 8.33%, and 9.83%, respectively). NG-DES implantation was associated with a lower risk of HHF than BMS implantation after 5 years, with an adjusted subdistribution hazard ratio of 0.82 (95% confidence interval 0.72−0.92, p = 0.001). These results accord with those of patients who received DAPT for >6 months. Our findings highlight that NG-DESs may reduce HHF risk in patients with STEMI receiving an undefined duration of DAPT.
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Chien et al. (2022) conducted a cohort in ST-elevation myocardial infarction (n=13,662). New-generation drug-eluting stent (NG-DES) vs. Bare-metal stent (BMS) was evaluated on Hospitalization for heart failure (HHF) at 5 years (SHR 0.82, 95% CI 0.72-0.92, p=0.001). New-generation drug-eluting stent implantation was associated with a lower 5-year risk of hospitalization for heart failure compared to bare-metal stents in patients with STEMI (SHR 0.82).
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