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Everolimus-eluting Versus Sirolimus-eluting Stents in Patients with ST Elevation Myocardial Infarction
APRIL 23e26, 2013
Coronary Stents Wednesday, April 24, 2013 2:00 PM w 6:00 PM (Abstract nos. AS-050, AS-053)
- AS-050 Two-year Comparison of Lesional Outcomes of Long Versus Short Drug-eluting Stent in One Patient with Two Vessel Disease. Yoon Jung Choi, Sung Yun Jung, Su Mi Kim, Sang Hee Lee, Ung Kim, Jong Seon Park, Dong Gu Shin, Young Jo Kim. Yeungnam University Medical Center, Daegu, Korea (Republic of).
P O S T E R
Background: Diffuse long coronary artery lesion remain difficult to treat in the era of durg-eluting stent (DES). The purpose of this study is to compare lesional outcomes of long and short stent implantation in one patient with two vessel disease. Methods: From May 2005 to August 2010, a total of 121 patients with 242 lesions who had two vessel disease and performed percutaneous coronary intervention (PCI) with long and short DES for the two lesions were enrolled. Long segment stent was defined as implantation of DES over 50 mm and short less than 50 mm. Same kind of DES were used in one patient. Angiographic follow-up was done at 8 months and clinical follow-up was done for 24 months. Study end-points were angiographic late loss, the rate of in-stent restenosis (ISR) defined as 50% of a diameter stenosis and major adverse cardiac events (MACE) including target lesion revascularization (TLR), target vessel revascularization (TVR) and lesion related myocardial infarction (MI). Results: Stent length was 62.512.5 mm in long lesion and 26.58.9 mm in short lesion. Follow-up angiography was performed in 48.8% (59/121). In-stent restenosis was observed in 8.9% in long lesion and 2.4% in short lesion (p¼0.124). Late loss at 8 months was statistically significant (0.710.61 mm in long lesion vs. 0.420.53 mm in short lesion, p<0.001). Myocardial infarction was observed in 1.7% in long lesion and none in short lesion for 24 months (p¼0.498). Target lesion revascularization was observed in 2.5% in long lesion and 0.8%
in short lesion (p¼0.370). Target vessel revascularization was observed in 3.3% in long lesion and 1.7% in short lesion (p¼0.684). Total MACE was observed 5.0% in long lesion and 3.3% in short lesion (p¼0.749). And Two sudden cardiac deaths without diagnostic confirmation were observed. Conclusion: There were higher late loss in long lesion than short lesions. However, clinical outcomes between long and short lesion for 24 months were not different. Further longer term follow-up and larger population study will be needed.
- AS-053 Everolimus-eluting Versus Sirolimus-eluting Stents in Patients with ST Elevation Myocardial Infarction. Chang Hee Kwon, Gyung-Min Park, Young-Rak Cho, Jung-Min Ahn, Won-Jang Kim, Jong-Young Lee, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park. Asan Medical Center, Seoul, Korea (Republic of). Background: To compare clinical outcomes of everolimus-eluting stents (EES) and sirolimus-eluting stents (SES) implantation in patients with ST elevation myocardial infarction (STEMI) underwent primary percutaneous coronary intervention. The safety and efficacy of EES in STEMI was undetermined. Methods: From the IRIS-DES registry, we identified 732 patients with STEMI undergoing primary percutaneous coronary intervention; 409 (55.9%) with EES group and 323 (44.1%) treated with SES. The primary end point was the composite of death, myocardial infarction, or target vessel revascularization (MACE) at 2-year follow-up. Results: At 2 year follow-up, the incidence of MACE was 6.8% in patients receiving EES and 9.6% in patients receiving SES (p¼0.15). The composite of death or myocardial infarction occurred lower in EES than in SES (3.4% vs. 7.1%, respectively, p¼0.023). The incidence of target vessel revascularization was similar between groups (4.2% vs. 2.5%, respectively, p¼0.27). However, after adjustment of baseline characteristics, there were no statistical differences with regard to the adjusted risk of MACE (hazard ratio [HR] 0.597, 95% confidence interval [CI] 0.26-1.36, p¼0.22), the composite of death or myocardial infarction (HR 0.38, 95% CI 0.13-1.16, p¼0.09) and target vessel revascularization (HR 1.60, 95% CI 0.69-3.72, p¼0.27). The incidence of definite or probable stent thrombosis was 1.0% with EES and 0.3% with SES (p¼0.276). Conclusion: In this large-scale, practical observational trial, EES implantation in patients with STEMI appeared to be safe and effective and showed the similar rate of MACE as compared to SES implantation.
A B S T R A C T S
76B
The American Journal of Cardiologyâ APRIL 23e26, 2013 ANGIOPLASTY SUMMIT ABSTRACTS/Poster
Coronary Stents Wednesday, April 24, 2013 2:00 PM w 6:00 PM (Abstract nos. AS-050, AS-053)
- AS-050 Two-year Comparison of Lesional Outcomes of Long Versus Short Drug-eluting Stent in One Patient with Two Vessel Disease. Yoon Jung Choi, Sung Yun Jung, Su Mi Kim, Sang Hee Lee, Ung Kim, Jong Seon Park, Dong Gu Shin, Young Jo Kim. Yeungnam University Medical Center, Daegu, Korea (Republic of).
P O S T E R
Background: Diffuse long coronary artery lesion remain difficult to treat in the era of durg-eluting stent (DES). The purpose of this study is to compare lesional outcomes of long and short stent implantation in one patient with two vessel disease. Methods: From May 2005 to August 2010, a total of 121 patients with 242 lesions who had two vessel disease and performed percutaneous coronary intervention (PCI) with long and short DES for the two lesions were enrolled. Long segment stent was defined as implantation of DES over 50 mm and short less than 50 mm. Same kind of DES were used in one patient. Angiographic follow-up was done at 8 months and clinical follow-up was done for 24 months. Study end-points were angiographic late loss, the rate of in-stent restenosis (ISR) defined as 50% of a diameter stenosis and major adverse cardiac events (MACE) including target lesion revascularization (TLR), target vessel revascularization (TVR) and lesion related myocardial infarction (MI). Results: Stent length was 62.512.5 mm in long lesion and 26.58.9 mm in short lesion. Follow-up angiography was performed in 48.8% (59/121). In-stent restenosis was observed in 8.9% in long lesion and 2.4% in short lesion (p¼0.124). Late loss at 8 months was statistically significant (0.710.61 mm in long lesion vs. 0.420.53 mm in short lesion, p<0.001). Myocardial infarction was observed in 1.7% in long lesion and none in short lesion for 24 months (p¼0.498). Target lesion revascularization was observed in 2.5% in long lesion and 0.8%
in short lesion (p¼0.370). Target vessel revascularization was observed in 3.3% in long lesion and 1.7% in short lesion (p¼0.684). Total MACE was observed 5.0% in long lesion and 3.3% in short lesion (p¼0.749). And Two sudden cardiac deaths without diagnostic confirmation were observed. Conclusion: There were higher late loss in long lesion than short lesions. However, clinical outcomes between long and short lesion for 24 months were not different. Further longer term follow-up and larger population study will be needed.
- AS-053 Everolimus-eluting Versus Sirolimus-eluting Stents in Patients with ST Elevation Myocardial Infarction. Chang Hee Kwon, Gyung-Min Park, Young-Rak Cho, Jung-Min Ahn, Won-Jang Kim, Jong-Young Lee, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park. Asan Medical Center, Seoul, Korea (Republic of). Background: To compare clinical outcomes of everolimus-eluting stents (EES) and sirolimus-eluting stents (SES) implantation in patients with ST elevation myocardial infarction (STEMI) underwent primary percutaneous coronary intervention. The safety and efficacy of EES in STEMI was undetermined. Methods: From the IRIS-DES registry, we identified 732 patients with STEMI undergoing primary percutaneous coronary intervention; 409 (55.9%) with EES group and 323 (44.1%) treated with SES. The primary end point was the composite of death, myocardial infarction, or target vessel revascularization (MACE) at 2-year follow-up. Results: At 2 year follow-up, the incidence of MACE was 6.8% in patients receiving EES and 9.6% in patients receiving SES (p¼0.15). The composite of death or myocardial infarction occurred lower in EES than in SES (3.4% vs. 7.1%, respectively, p¼0.023). The incidence of target vessel revascularization was similar between groups (4.2% vs. 2.5%, respectively, p¼0.27). However, after adjustment of baseline characteristics, there were no statistical differences with regard to the adjusted risk of MACE (hazard ratio [HR] 0.597, 95% confidence interval [CI] 0.26-1.36, p¼0.22), the composite of death or myocardial infarction (HR 0.38, 95% CI 0.13-1.16, p¼0.09) and target vessel revascularization (HR 1.60, 95% CI 0.69-3.72, p¼0.27). The incidence of definite or probable stent thrombosis was 1.0% with EES and 0.3% with SES (p¼0.276). Conclusion: In this large-scale, practical observational trial, EES implantation in patients with STEMI appeared to be safe and effective and showed the similar rate of MACE as compared to SES implantation.
A B S T R A C T S
76B
The American Journal of Cardiologyâ APRIL 23e26, 2013 ANGIOPLASTY SUMMIT ABSTRACTS/Poster