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Two-year clinical outcomes of zotarolimus- and everolimus-eluting durable-polymer-coated stents versus biolimus-eluting biodegradable-polymer-coated stent in patients with acute myocardial infarction with dyslipidemia after percutaneous coronary intervention: data from the KAMIR

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Abstract

There are limited data comparing the clinical outcomes among new-generation drug-eluting stents (DES) in acute myocardial infarction (AMI) patients with dyslipidemia after percutaneous coronary intervention (PCI). We thought to investigate 2-year clinical outcomes among durable-polymer (DP)-coated stents [zotarolimus eluting (ZES) and everolimus eluting (EES)] and biodegradable-polymer (BP)-coated biolimus-eluting stent (BES) in dyslipidemic AMI patients after PCI. Finally, a total 2403 enrolled patients were divided into ZES (n = 953), EES (n = 1145) or BES (n = 305) group. The primary endpoint was major adverse cardiac events (MACE) defined as total death (TD), cardiac death (CD), myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR) and non-TVR. The secondary endpoint was the incidence of definite or probable stent thrombosis (ST). The 2-year adjusted hazard ratio (HR) of MACE for ZES vs. EES [HR, 1.066; 95% confidence interval (CI) 0.752–1.511; p = 0.720], ZES vs. BES (HR 0.933; 95% CI 0.565–1.541; p = 0.786), EES vs. BES (HR 1.876; 95% CI 0.535–1.436; p = 0.600) and ZES/EES vs. BES (HR 0.929; 95% CI 0.591–1.462; p = 0.751) was similar. The cumulative incidences of ST were comparable (ZES vs. EES vs. BES = 1.1% vs. 0.9% vs. 1.1%, p = 0.675) and adjusted HR was not different. In addition, the 2-year adjusted HR of TD, CD, MI, TLR, TVR, and non-TVR was similar. The AMI patients with dyslipidemia receiving ZES, EES, or BES after PCI showed comparable safety and efficacy during 2-year follow-up periods. Therefore, DP-DES or BP-DES is equally acceptable in dyslipidemic AMI patients during PCI.

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Abbreviations

AMI:

Acute myocardial infarction

BES:

Biolimus-eluting stents

BP:

Biodegradable polymer

DES:

Drug-eluting stents

DP:

Durable polymer

EEE:

Everolimus-eluting stent

MACE:

Major adverse cardiac events

PCI:

Percutaneous coronary intervention

PES:

Paclitaxel-eluting stent

SES:

Sirolimus-eluting stent

ST:

Stent thrombosis

TLR:

Target lesion revascularization

TVR:

Target vessel revascularization

ZES:

Zotarolimus-eluting stent

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  1. Yong Hoon Kim and Ae-Young Her contributed equally to this work as first authors.

Authors and Affiliations

  1. Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, 156 Baengnyeong Road, Chuncheon, Gangwon, 24289, South Korea

    Yong Hoon Kim & Ae-Young Her

  2. Chonnam National University Hospital, Gwangju, Republic of Korea

    Myung Ho Jeong

  3. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Byeong-Keuk Kim, Sung-Jin Hong, Dong-Ho Shin, Jung-Sun Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong & Yangsoo Jang

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Kim, Y.H., Her, AY., Jeong, M.H. et al. Two-year clinical outcomes of zotarolimus- and everolimus-eluting durable-polymer-coated stents versus biolimus-eluting biodegradable-polymer-coated stent in patients with acute myocardial infarction with dyslipidemia after percutaneous coronary intervention: data from the KAMIR. Heart Vessels 34, 237–250 (2019). https://doi.org/10.1007/s00380-018-1251-0

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