Key result
Second-generation drug-eluting stents did not significantly reduce the 5-year risk of major adverse cardiac events compared to first-generation stents in patients with acute myocardial infarction, though they significantly lowered target lesion and vessel revascularization rates.
Why the study?
Does the use of second-generation drug-eluting stents reduce major adverse cardiac events compared to first-generation drug-eluting stents in patients with acute myocardial infarction undergoing PCI?
Cohort (n=1,016)
No
Does the use of second-generation drug-eluting stents reduce major adverse cardiac events compared to first-generation drug-eluting stents in patients with acute myocardial infarction undergoing PCI?
Second-generation drug-eluting stents demonstrate superior 5-year efficacy in reducing the need for revascularization compared to first-generation stents in AMI patients, with comparable safety.
Answers are grounded in this paper and cite their sources.
Should not change stent selection for MACE reduction in AMI; leaves open revascularization benefits in real-world cohorts.
BACKGROUND: There were limited data comparing the major clinical outcomes between first-generation (1G)-drug eluting stents (DES) and second-generation (2G)-DES in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) during very long follow-up periods. We thought to investigate the comparative efficacy and safety of 2G-DES compared with 1G-DES in AMI patients during 5-year follow-up periods. METHOD: = 462] were enrolled. The primary endpoint was the occurrence of major adverse cardiac events (MACE) defined as total death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), non-target vessel revascularization (Non-TVR) and the secondary endpoint was stent thrombosis (ST) at 5 years. However, the incidence of total death, non-fatal MI and ST were similar between the two groups. CONCLUSION: In this single-center and all-comers registry, 2G-DES's superiorities for TLR, TVR and total revascularization in AMI patients suggested during 5-year clinical follow-up periods.
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Kim et al. (2018) conducted a cohort in Acute myocardial infarction (AMI) (n=1,016). Second-generation drug-eluting stents vs. First-generation drug-eluting stents was evaluated on Major adverse cardiac events (MACE) (HR 1.419, 95% CI 0.960-2.096, p=0.079). Second-generation drug-eluting stents did not significantly reduce the 5-year risk of major adverse cardiac events compared to first-generation stents in patients with acute myocardial infarction, though they significantly lowered target lesion and vessel revascularization rates.
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