Author + information
- Received April 5, 2019
- Revision received August 1, 2019
- Accepted August 13, 2019
- Published online January 6, 2020.
- Jeong Cheon Choe, MDa,b,
- Kwang Soo Cha, MD, PhDa,∗ (, )@ChoeJeongCheon,
- Jeong Gyu Lee, MD, PhDb,
- Jinmi Kim, PhDc,
- Ji Yeon Shin, MDa,
- Jinhee Ahn, MDa,
- Jin Sup Park, MDa,
- Hye Won Lee, MDa,
- Jun-Hyok Oh, MDa,
- Jung Hyun Choi, MDa,
- Han Cheol Lee, MDa,
- Taek Jong Hong, MDa,
- Myung Ho Jeong, MDd,
- Korea Acute Myocardial Infarction Registry-National Institutes of Health Investigators
- aDepartment of Cardiology and Medical Research Institute, Pusan National University Hospital, Busan, South Korea
- bHealth Promotion Center, Pusan National University Hospital, Busan, South Korea
- cDepartment of Biostatistics, Pusan National University Hospital, Busan, South Korea
- dDepartment of Cardiology, Chonnam National University Hospital, Gwangju, South Korea
- ↵∗Address for correspondence:
Dr. Kwang Soo Cha, Pusan National University, Department of Cardiology and Medical Research Institute, Pusan National University Hospital, 179 Gudeok-ro Seo-gu, Busan 49241, South Korea.
Objectives This study sought to compare outcomes between biodegradable polymer drug-eluting stent (BP-DES) and second-generation durable polymer drug-eluting stent (DP-DES) implantations for acute myocardial infarction (MI) using a nationwide dataset.
Background Data regarding outcomes of BP-DES versus second-generation DP-DES are inconclusive.
Methods Among 13,104 patients with acute MI in a nationwide registry who underwent percutaneous coronary intervention (November 2011 to December 2015), BP-DES and second-generation DP-DES were implanted in 2,261 (21.7%) and 8,182 patients (78.3%), respectively. Major adverse cardiac events (MACE) (all-cause death, recurrent MI, or any revascularization) were compared in multivariable Cox regression, propensity score (PS) matched, and underwent PS-adjusted analyses.
Results MACE occurred in 1,492 (14.3%) patients during a median 723-day follow-up. MACE were less frequent with BP-DES implantation than with second-generation DP-DES implantation (entire cohort hazard ratio [HR]: 0.845; 95% confidence interval [CI]: 0.740 to 0.965; PS-matched HR: 0.669; 95% CI: 0.550 to 0.814). Risk of all-cause death (entire cohort HR: 0.831; 95% CI: 0.692 to 0.997; PS-matched HR: 0.752; 95% CI: 0.495 to 0.931), cardiac death (entire cohort HR: 0.685; 95% CI: 0.542 to 0.865; PS-matched HR: 0.613; 95% CI: 0.463 to 0.872), recurrent MI (entire cohort HR: 0.662; 95% CI: 0.466 to 0.941; PS-matched HR: 0.611; 95% CI: 0.427 to 0.898), and heart failure readmission (entire cohort HR: 0.625; 95% CI: 0.447 to 0.875; PS-matched HR: 0.584; 95% CI: 0.385 to 0.887) was less with BP-DES implantation. There were no significant group differences in the incidences of any revascularization, stroke, and definite or probable stent thrombosis.
Conclusions In patients with acute MI who underwent percutaneous coronary intervention, BP-DES implantation is associated with improved outcomes compared with second-generation DP-DES implantation.
- acute myocardial infarction
- biodegradable polymer drug-eluting stent
- clinical outcome
- second-generation durable polymer drug-eluting stent
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received April 5, 2019.
- Revision received August 1, 2019.
- Accepted August 13, 2019.
- 2020 American College of Cardiology Foundation
This article requires a subscription or purchase to view the full text. If you are a subscriber or member, click Login or the Subscribe link (top menu above) to access this article.