Author + information
- Wenjie Tian,
- Rebecca Torguson,
- Ricardo Escarcega Alarcon,
- Marco De Magalhaes Pereira,
- Thibault Lhermusier,
- Nevin Baker,
- Hideaki Ota and
- Ron Waksman
Coronary intervention is infrequently performed in octogenarians and the clinical outcomes of drug-eluting stents (DES) in octogenarians with acute myocardial infarction (AMI) are limited. The aim of this study was to determine whether there are differences between the first- and second-generation DES for octogenarians with AMI.
Clinical data of 164 octogenarians with AMI who underwent first-generation DES (n=104, 167 lesions) or second-generation DES (n=60, 86 lesions) implantation were retrospectively analyzed. The primary endpoint was the rate of major adverse cardiac events (MACE) at 1 year follow-up.
Baseline clinical and procedural characteristics were similar between the two groups, except for less left main lesions (3.6% vs. 10.5%, p=0.027) and greater stent length (20.06±8.29mm vs. 16.16±4.85mm, p<0.001) in the first-generation DES group. The clinical success rate was similar in the two groups (89.4% vs. 96.7%, p=0.136). Compared with second-generation DES group, there were no differences in the occurrence of MACE (27.2% vs. 21.7%, p=0.434), TLR (5.7% vs. 7.4%, p=1.000) and all-cause death (23.3% vs. 15.0%, p=0.203) in the second-generation DES group at 1-year follow-up. The occurrence of stent thrombosis was similar (1% vs. 0%, p=1.000) in the two groups.
The occurrence of MACE, mainly driven by all-cause death, was high in octogenarians with AMI. The first- and second-generation DES resulted in comparable outcomes at 1 year follow-up.
|Variable||1-st generation DES|
(n=104, 167 lesions)
|2-nd generation DES|
(n=60, 86 lesions)
|6 months follow-up (%)|
|All cause death||17.3||10.0||0.202|
|1 year follow-up (%)|
|All cause death||23.3||15.0||0.203|
MACE: Major adverse cardiac events; MI: Myocardial infarction; TLR: Target lesion revascularization