One-year clinical outcomes of everolimus-versus sirolimus-eluting stents in patients with acute myocardial infarction

Abstract

Background: In contrast to many studies comparing everolimus-eluting stent (EES) with paclitaxel-eluting stent (PES), data directly comparing EES with sirolimus-eluting stent (SES) are limited, especially in patients with acute myocardial infarction (AMI). Methods: This study includes 2911 AMI patients treated with SES (n = 1264) or EES (n = 1701) in Korea Acute Myocardial Infarction Registry (KAMIR). Propensity score matching was applied to adjust for baseline imbalance in clinical and angiographic characteristics, yielding a total of 2400 well-matched patients (1200 receiving SES and 1200 receiving EES). One-year clinical outcomes were compared between the two propensity score matched groups. Results: Baseline clinical and angiographic characteristics were similar between the two propensity score matched groups One-year clinical outcomes of the propensity score matched cohort were comparable between the EES versus the SES groups including the rates of cardiac death (4.8% vs. 4.8%, P = 1.000), recurrent myocardial infarction (1.4% vs. 1.7%, P = 0.619), target lesion revascularization (1.4% vs. 1.6%, P = 0.737), target lesion failure (7.0% vs. 7.3%, P = 0.752), and probable or definite stent thrombosis (0.5% vs. 0.9%, P = 0.224) except for a trend toward lower incidence of target vessel revascularization (1.9% vs. 3.0%, P = 0.087) and a lower rate of total major adverse cardiac events (9.3% vs. 11.9%, P = 0.034) in the EES group. Conclusions: The present propensity score matched analysis performed in a large-scale, prospective, multicenter registry suggests that the second-generation drug-eluting stent EES has at least comparable or even better safety and efficacy profiles as compared with SES in the setting of AMI. (C) 2014 Elsevier Ireland Ltd. All rights reserved.