AI Summary & Key Takeaways
AI InsightDespite increased incidence of MACE, re-MI and ST in 1-year, DES was found to be non-inferior to BMS at 2-year follow up.
📌 3 Key Takeaways
Abstract
Background: The aim of this study was to compare the effectiveness and safety of drug eluting stents (DES) with bare metal stents (BMS) in patients presented with ST- segment elevation myocardial infarction (STEMI) in a real world setting. Methods: One thousand five hundred ninety six STEMI patients treated with primary percutaneous coronary intervention from January 2013 to March 2016 were enrolled to study. One thousand one hundred ninety four of them received BMS while 402 of them received DES. Patients were analyzed for major adverse cardiac events (MACE) and stent thrombosis (ST). Results: There was no difference at 30 days in relation of MACE, all cause death, re-MI, TVR, TLR and ST. The cumulative incidence of MACE was significantly higher in DES group (9,2% vs. 7,0%, p = 0.02) at 1 year. Stent thrombosis and re-MI incidence were significantly higher in DES group (4,2% vs. 2,6%, p = 0.028, 6,9% vs. 4,8%, p = 0.015) respectively at 1 year. There was no statistically significant difference in relation of all cause death, TVR and TLR at 1 year. The statistically differences between groups vanished at 2 year and the groups looked similar. Male gender (HR, 1.40; 95% CI, 1.00 to 1.94; p = 0.043) and presence of DM (HR, 1.73; 95% CI, 1.29 to 2.32; p<0,001) were found to be independent predictors of 2-year MACE. Conclusion: Our study showed effectiveness and safety of DES in STEMI. Despite increased incidence of MACE, re-MI and ST in 1-year, DES was found to be non-inferior to BMS at 2-year follow up.
Özet
Amaç: Bu çalışmada ST segment elevasyonlu myokard enfarktüsünde ilaç kaplı stentleri ve çıplak metal stentleri karşılaştırmak istedik. Gereç ve Yöntem: Çalışmamıza merkezimize Ocak 2013 ve Mart 2016 tarihleri arasında başvuran toplam 1596 ST segment elevasyonlu myokard enfarktüsü alındı. Katılımcılar çıplak metal stent grubu (n=1194) ve ilaç kaplı stent grubu (n=402) olarak iki gruba ayrıldı. Hastalar major kardiyak sonlanım acısından değerlendirildi. Bulgular: Grublar arasında ilk 30 günde major kardiyak sonlanım ve tüm ölüm açısından fark olmamasına rağmen, toplam major kardiyak sonlanım insidansı (9,2% vs. 7,0%, p=0.02), stent thrombozu (4,2% vs. 2,6%, p=0.028) ve tekrar myokard enfarktüsü (6,9% vs. 4,8%, p=0.015) ilaç kaplı stent grubunda yüksek bulundu. Bununla birlikte toplam mortalitede, hedef damar ve lezyon revaskülarizasyonunda istatiksel anlamlı fark bulunmadı. Major kardiyak sonlanım ve toplam mortalite 2 yıllık takipte gruplar arasında benzer bulundu. Erkek cinsiyet (HR, 1.40; 95% CI, 1.00 to 1.94; p = 0.043) ve diyabet varlığı (HR, 1.73; 95% CI, 1.29 to 2.32; p<0,001) major kardiyak sonlanım için bağımsız prediktör olarak saptandı.Sonuç: Sonuclarımız ilaç kaplı stentlerin çıplak metal stentler ile karşılaştırıldığında hem etkili hem de güvenli oldugunu gösterdi.