Skip to main content

Advertisement

SpringerLink
Log in

Midterm outcomes of bare-metal stenting after primary stenting for ST-segment elevated myocardial infarctions in the drug-eluting stent era: a propensity score-matched comparison with sirolimus-eluting stent

  • Original Article
  • Published:
Cardiovascular Intervention and Therapeutics Aims and scope Submit manuscript

Abstract

We performed a propensity score-matching comparison of the midterm clinical and angiographic outcomes after primary stenting between using bare-metal stents (BMSs) and sirolimus-eluting stent (SES; Cypher Bx Velocity) for ST-segment elevated myocardial infarction (STEMI), because, in the drug-eluting stent era, the indication of the BMSs when a large balloon diameter is required remained to be controversial. This was a single-center, nonrandomized, retrospective study investigated in October 2013 by enrolling STEMI patients treated with primary stenting using either SES (n = 468) or BMS (n = 171) between September 2004 and December 2011. In 204 patients, the baseline-adjusted values produced similar mean maximum balloon sizes (BMS 3.67 ± 0.47 mm; SES 3.70 ± 0.56 mm; p = 0.477), and the incidence rates of binary in-stent restenosis (% diameter stenosis >50 % on secondary angiography) after SES placement (7.8 %) was significantly lower than that after BMS placement (23.5 %; p = 0.002). In baseline-adjusted 300 patients, the incidence of the clinical endpoints comprising cardiac death, nonfatal recurrent MI, and definite stent thrombosis after SES placement (11.3 %; 1241 ± 786 days; p = 0.557) was not significantly different from after BMS placement (8.7 %; mean follow-up period, 549 ± 486 days; p = 0.557). SES was not significantly related to the clinical endpoint [hazard ratio 2.31; 95 % confidence interval (CI) 0.88–6.08; p = 0.089). BMS did not offset the SES’s angiographic efficacy for primary stenting for STEMI patients, despite placed using a large-sized balloon.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC), Steg PG, James SK, Atar D, Badano LP, Blömstrom-Lundqvist C, Borger MA, Di Mario C, Dickstein K, Ducrocq G, Fernandez-Aviles F, Gershlick AH, Giannuzzi P, Halvorsen S, Huber K, Juni P, Kastrati A, Knuuti J, Lenzen MJ, Mahaffey KW, Valgimigli M, van 't Hof A, Widimsky P, Zahger D. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2012;33(20):2569–619. doi:10.1093/eurheartj/ehs215.

  2. Shugman IM, Hee L, Mussap CJ, Diu P, Lo S, Hopkins AP, Nguyen P, Taylor D, Rajaratnam R, Leung D, Thomas L, Juergens CP, French JK. Bare-metal stenting of large coronary arteries in ST-elevation myocardial infarction is associated with low rates of target vessel revascularization. Am Heart J. 2013;165:591–9.

    Article  PubMed  Google Scholar 

  3. Suzuki N, Kozuma K, Tanabe K, Ikari Y, Muramatsu T, Isshiki T. Clinical and angiographic outcomes after bare metal stents implantation for the patients with acute ST-elevation myocardial infarction: insights from multicenter trials. Cardiovasc Interv Ther. 2010;25:98–104.

    Article  PubMed  Google Scholar 

  4. Takano T, Ogawa S, Kasanuki H, Kimura K, Goto Y, Sumiyoshi T, Daida H, Tanaka K, Nagao K, Hirayama A, Makuuchi H, Yamaguchi T, Yamashina A, Yoshina H. Guidelines for the management of patients with ST-elevation myocardial infarction (JCS 2008). Circ J. 2008;72 Suppl:1347–411.

    Google Scholar 

  5. Ishikawa K, Ueshima H, Ogawa H, Kanamasa K, Saito M, Sasaki J, et al. Guidelines for the Diagnosis and Treatment of Cardiovascular Diseases (2004–2005 Joint Working Groups Report). Guidelines for Secondary Prevention of Myocardial Infarction (JCS 2006). http://www.j-circ.or.jp/guideline/pdf/JCS2006_ishikawa_h.pdf (in Japanese).

  6. Ishikawa T, Mutoh M, Nakano Y, Endo A, Kubota T, Suzuki T, Nakata K, Murakami A, Miyamoto T, Sakamoto H, Okada H, Imai K, Yoshimura M. Retrospective comparison of clinical and angiographic outcomes after primary stenting using sirolimus-eluting and bare-metal stents in nonrandomized consecutive 568 patients with first ST-segment elevated myocardial infarctions. J Cardiol. 2011;57:44–52.

    Article  PubMed  Google Scholar 

  7. Ishikawa T, Nakano Y, Hino S, Mutoh M. Comparison of long-term clinical and 1-year angiographic outcomes after primary stenting (~12 h) and late reperfusion (~12 h) using sirolimus-eluting stent for ST-segment elevated myocardial infarction: a propensity score matching analysis. Intern Med. 2013;52:1303–10.

    Article  PubMed  Google Scholar 

  8. Ishikawa T, Mutoh M, Nakano Y, Suzuki T, Nakata K, Murakami A, Miyamoto T, Yoshimura M. Post-discharge clinical and angiographic outcomes of patients presenting within 48 hours of STEMI treated with paclitaxel- or sirolimus-eluting stents. J Cardiol. 2012;60(3):174–9. doi:10.1016/j.jjcc.2012.03.009.

    Article  PubMed  Google Scholar 

  9. Cutlip DE, Windecker S, Mehran R, Boam A, Cohen DJ, van Es GA, Steg PR, Morel MA, Mauri L, Vranckx P, McFadden E, Lansky A, Hamon M, Krucoff MW, Serruys PW, Academic Research Consortium. Academic Research Consortium. Clinical endpoints in coronary stent trials: a case for standardized definitions. Circulation. 2007;115:2344–51.

    Article  PubMed  Google Scholar 

  10. D’Agostino RB Jr. Propensity scores in cardiovascular research. Circulation. 2007;115:2340–3.

    Article  PubMed  Google Scholar 

  11. Musto C, Fiorilli R, De Felice F, Patti G, Nazzaro MS, Scappaticci M, Bernardi L, Violini R. Long-term outcome of sirolimus-eluting vs bare-metal stent in the setting of acute myocardial infarction: 5-year results of the SESAMI trial. Int J Cardiol. 2013;166:399–403.

    Article  PubMed  Google Scholar 

  12. Spaulding C, Teiger E, Commeau P, Varenne O, Bramucci E, Slama M, Beatt K, Tirouvanziam A, Polonski L, Stella PR, Clugston R, Fajadet J, de Boisgelin X, Bode C, Carrie D, et al. Four-year follow-up of TYPHOON (trial to assess the use of the CYPHer sirolimus-eluting coronary stent in acute myocardial infarction treated with BallOON angioplasty). JACC Cardiovasc Interv. 2011;4:14–23.

    Article  PubMed  Google Scholar 

  13. De Luca G, Dirksen MT, Spaulding C, Kelbaek H, Schalij M, Thuesen L, van der Hoeven B, Vink MA, Kaiser C, Musto C, Chechi T, Spaziani G, Díaz de la Llera LS, Pasceri V, Di Lorenzo E, Violini R, Cortese G, Suryapranata H, Stone GW, Drug-Eluting Stent in Primary Angioplasty (DESERT) Cooperation. Drug-eluting vs bare-metal stents in primary angioplasty: a pooled patient-level meta-analysis of randomized trials. Arch Intern Med. 2012;172:611–21.

  14. Yoshikawa D, Isobe S, Umeda H, Kawai T, Shimizu T, Yamashita K, Ishii H, Murohara T. Three-year prognosis of Japanese patients with ST-elevation myocardial infarction treated with sirolimus-eluting stents. Coron Artery Dis. 2009;20:422–7.

    Article  PubMed  Google Scholar 

  15. Ejiri K, Ishihara M, Dai K, Miki T, Inoue I, Kawagoe T, Shimatani Y, Miura F, Nakama Y, Otani T, Ikenaga H, Oda N, Nakamura M. Three-year follow-up of sirolimus-eluting stents vs. bare metal stents for acute myocardial infarction. Circ J. 2012;76:65–70.

    Article  PubMed  Google Scholar 

  16. Kimura T, Morimoto T, Kozuma K, Honda Y, Kume T, Aizawa T, Mitsudo K, Miyazaki S, Yamaguchi T, Hiyoshi E, Nishimura E, Isshiki T. RESTART Investigators. Comparisons of baseline demographics, clinical presentation, and long-term outcome among patients with early, late, and very late stent thrombosis of sirolimus-eluting stents: observations from the Registry of Stent Thrombosis for Review and Reevaluation (RESTART). Circulation. 2010;122:52–61.

    Article  PubMed  Google Scholar 

  17. van Werkum JW, Heestermans AA, Carla Zomer A, Kelder JC, Suttorp MJ, Rensing BJ, Koolen JJ, Brueren G, Dambrink JHE, Hautvast RW, Verheugt FW, ten Berg JM. Predictors of coronary stent thrombosis: the Dutch stent thrombosis registry. J Am Coll Cardiol. 2009;53:1399–409.

    Article  PubMed  Google Scholar 

  18. Joner M, Finn AV, Farb A, Mont EK, Kolodgie FD, Ladich E, Kutys R, Skorija K, Gold HK, Virmani R. Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. J Am Coll Cardiol. 2006;48:193–202.

    Article  PubMed  Google Scholar 

  19. Cook S, Ladich E, Nakazawa G, Eshtehardi P, Neidhart M, Vogel R, Togni M, Wenaweser P, Billinger M, Seiler C, Gay S, Meier B, Pichler WJ, Juni P, Virmani R, Windecker S. Correlation of intravascular ultrasound findings with histopathological analysis of thrombus aspirates in patients with very late drug-eluting stent thrombosis. Circulation. 2009;120:391–9.

    Article  PubMed  Google Scholar 

  20. Nakagawa Y. What is the effectiveness of drug-eluting stents in the treatment of ST-elevation myocardial infarction?: should drug-eluting stents be indicated for patients with acute coronary syndrome? (Pro). Circ J. 2010;74:2225–31 (Epub 2010 Aug 31).

    Article  PubMed  Google Scholar 

  21. Inoue K. Drug-eluting stents are not indicated for patients with acute coronary syndrome: should drug-eluting stents be indicated for patients with acute coronary syndrome? (Con). Circ J. 2010;74:2232–8 (Epub 2010 Aug 31).

    Article  PubMed  Google Scholar 

  22. Kimura T, Morimoto T, Nakagawa Y, Kawai K, Miyazaki S, Muramatsu T, Shiode N, Namura M, Sone T, Oshima S, Nishikawa H, Hiasa Y, Hayashi Y, Nobuyoshi M, Mitudo K, j-Cypher Registry Investigator; j-Cypher Registry Investigators. Very late stent thrombosis and late target lesion revascularization after sirolimus-eluting stent implantation: five-year outcome of the j-Cypher Registry. Circulation. 2012;125:584–91.

    Article  CAS  PubMed  Google Scholar 

  23. Nakano Y, Ishikawa T, Hino S, Mutoh M. Propensity score matched lesion-based comparison of long-term clinical and angiographic outcomes after placement of sirolimus (Cypher Bx Velocity) and paclitaxel (TAXUS Express)-eluting stents for de novo native coronary stenosis. Cardiovasc Interv Ther. 2014;29(2):93–101.

    Article  CAS  PubMed  Google Scholar 

  24. Nakamura M, Yamagishi M, Ueno T, Hara K, Ishiwata S, Itoh T, Hamanaka I, Wakatsuki T, Sugano T, Kawai K, Kimura T. Current treatment of ST elevation acute myocardial infarction in Japan: door-to-balloon time and total ischemic time from the J-AMI registry. Cardiovasc Interv Ther. 2013;28(1):30–6. doi:10.1007/s12928-012-0128-x (Epub 2012 Sep 16).

    Article  PubMed  Google Scholar 

  25. Brodie B, Pokharel Y, Fleishman N, Bensimhon A, Kissling G, Hansen C, Milks S, Cooper M, McAlhany C, Stuckey T. Very late stent thrombosis after primary percutaneous coronary intervention with bare-metal and drug-eluting stents for ST-segment elevation myocardial infarction: a 15-year single-center experience. JACC Cardiovasc Interv. 2011;4(1):30–8. doi:10.1016/j.jcin.2010.11.004.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Smith SC Jr, Dove JT, Jacobs AK, Kennedy JW, Kereiakes D, Kern MJ, Kuntz RE, Popma JJ, Schaff HV, Williams DO, Gibbons RJ, Alpert JP, Eagle KA, Faxon DP, Fuster V, Gardner TJ, Gregoratos G, Russell RO, Smith SC Jr, American College of Cardiology/American Heart Association task force on practice guidelines (committee to revise the 1993 guidelines for percutaneous transluminal coronary angioplasty); Society for Cardiac Angiography and Interventions. ACC/AHA guidelines for percutaneous coronary intervention (revision of the 1993 PTCA guidelines)—executive summary: a report of the American College of Cardiology/American Heart Association task force on practice guidelines (committee to revise the 1993 guidelines for percutaneous transluminal coronary angioplasty) endorsed by the Society for Cardiac Angiography and Interventions. Circulation. 2001;103:3019–41.

Download references

Conflict of interest

None declared.

Author information

Authors and Affiliations

  1. Division of Cardiology, Saitama Cardiovascular Respiratory Center, 1696 Itai, Kumagaya, Saitama, 360-3197, Japan

    Kotaro Nakata, Tetsuya Ishikawa, Yosuke Nakano & Makoto Mutoh

  2. Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan

    Michihiro Yoshimura

Authors
  1. Kotaro Nakata
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tetsuya Ishikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yosuke Nakano
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michihiro Yoshimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Makoto Mutoh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tetsuya Ishikawa.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nakata, K., Ishikawa, T., Nakano, Y. et al. Midterm outcomes of bare-metal stenting after primary stenting for ST-segment elevated myocardial infarctions in the drug-eluting stent era: a propensity score-matched comparison with sirolimus-eluting stent. Cardiovasc Interv and Ther 30, 234–243 (2015). https://doi.org/10.1007/s12928-014-0309-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12928-014-0309-x

Keywords

Search

Navigation