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ȣ - 540137 38 |
Effectiveness of Drug-Eluting Stents versus Bare-Metal Stents in Large Coronary Arteries in Patients with Acute Myocardial Infarction |
1전남대학교병원, 2영남대학교병원, 3경북대학교병원, 4부산대학교병원, 5충남대학교병원, 6전북대학교병원, 7경희대학교병원, 8충북대학교병원, 9카톨릭대학교병원, 10서울아산병원 |
심두선1, 정명호1, 안영근1, 김영조2, 채성철3, 홍택종4, 성인환5, 채제건6, 김종진7, 조명찬8, 승기배9, 박승정10 외 한국급성심근경색증 연구회 연구자 |
Background: Effectiveness of drug-eluting stents (DES) versus bare-metal stents (BMS) in large vessels remains controversial, particularly in patients with acute myocardial infarction (MI).
Objective: This study compared clinical outcomes of DES versus BMS in large coronary arteries in patients with acute MI.
Methods: A total of 985 patients who underwent single-vessel percutaneous coronary intervention (PCI) with a stent ≥3.5 mm in diameter and <25 mm in length were divided into 2 groups (DES group: n=841 and BMS group: n=144). Clinical outcomes at 30 days, 6 and 12 months were compared. Propensity score analysis with logistic regression was used to control for confounders.
Results: In-hospital outcome was similar between the groups. At six months, death/MI rate was not different. However, DES group had significantly lower rates of target-lesion revascularization (TLR) (1.7% vs. 5.6%, p=0.021), target-vessel revascularization (TVR) (2.2% vs. 5.6%, p=0.032), and total major adverse cardiac events (MACE) (3.4% vs. 11.9%, p=0.025). At 12 months, the rates of TLR and TVR remained lower in the DES group (2.5% vs. 5.9%, p=0.032 and 5.9 vs. 3.1%, p=0.041), but the rates of death/MI and total MACE were not statistically different.
Conclusion: The use of DES in large vessels in the setting of acute MI was associated with lower need for repeat revascularization without increasing the overall safety during 1-year follow-up.
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