Five-year outcomes of ST-elevation myocardial infarction versus non-ST-elevation acute coronary syndrome treated with biodegradable polymer-coated sirolimus-eluting stents: Insights from the CREATE trial
| Autor: | Quan-min Jing, Dong-xing Ma, Yaling Han, Wei Han, Wei-min Li, Ying Liu, Runlin Gao, Peng Qu, Zhi-geng Jin, Jian-ping Luo, Tie-min Jiang, Li-xia Yang, Lei Zhang, Hui-liang Liu, Shu-mei Li, Bo Xu, Sheng-li Yang |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Acute coronary syndrome medicine.medical_specialty Time Factors Polymers 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine Post-hoc analysis Absorbable Implants medicine Humans cardiovascular diseases 030212 general & internal medicine Myocardial infarction Acute Coronary Syndrome Aged Sirolimus Aspirin business.industry Mortality rate ST elevation Drug-Eluting Stents Middle Aged medicine.disease Clopidogrel Anti-Bacterial Agents Treatment Outcome Cardiology ST Elevation Myocardial Infarction Female Cardiology and Cardiovascular Medicine business Mace medicine.drug |
| Zdroj: | Journal of cardiology. 69(1) |
| ISSN: | 1876-4738 |
| Popis: | Background Long-term outcome of drug-eluting stents (DES) for ST-elevation myocardial infarction (STEMI) versus non-ST-elevation acute coronary syndrome (NSTE-ACS) remains unclear. This study sought to compare the long-term outcomes of biodegradable polymer-coated DES in patients with STEMI versus NSTE-ACS. Methods We explored a post hoc analysis of the 5-year outcome of the CREATE trial in the subgroup of patients with STEMI ( n = 318) versus NSTE-ACS ( n = 1223) who were implanted with biodegradable polymer-coated DES. The primary outcome was the rate of major adverse cardiac events (MACE) at 5 years. Clopidogrel and aspirin for 6 months followed by chronic aspirin therapy were recommended. Results STEMI patients showed a trend of increase in MACE (8.7% vs. 6.8%, log rank p = 0.289) compared to NSTE-ACS patients at 5 years, and a greater risk of cardiac death (5.4% vs. 2.1%, log rank p = 0.003), mainly driven by the higher cardiac death rate within the first month after stent placement (log rank p = 0.003) and the last year of follow-up (log rank p = 0.001). No significant difference in stent thrombosis was found between them (3.1% vs. 2.5%, log rank p = 0.653). Prolonged clopidogrel therapy (>6 months) showed no effect on risk of MACE or stent thrombosis between the two groups (both p for interaction >0.1). Conclusions STEMI patients have a higher risk of cardiac mortality compared with NSTE-ACS patients after biodegradable polymer-coated DES placement, primarily attribute to more cardiac deaths that happened within the first month after the event and the last year of follow-up. |
| Databáze: | OpenAIRE |
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