Abstract
sThis study aims to investigate the two-year clinical outcomes between first-generation (1G) and second-generation (2G) drug-eluting stents (DES) based on pre-percutaneous coronary intervention (PCI) thrombolysis in myocardial infarction (TIMI) flow grade (pre-TIMI) in patients with ST-segment elevation myocardial infarction (STEMI). Overall, 17,891 STEMI patients were classified into two groups: pre-TIMI 0/1 group (n = 12,862; 1G-DES (n = 4318), 2G-DES (n = 8544)) and pre-TIMI 2/3 group (n = 5029; 1G-DES (n = 2046), 2G-DES (n = 2983)). During a two-year follow-up period, major adverse cardiac events (MACEs) defined as all-cause death, recurrent myocardial infarction (re-MI), or any repeat revascularization and stent thrombosis (ST) were considered as the primary and the secondary outcomes. In the pre-TIMI 0/1 and 2/3 groups, the cumulative incidences of MACEs (adjusted hazard ratio (aHR): 1.348, p < 0.001, and aHR: 1.415, p = 0.02, respectively) and any repeat revascularization (aHR: 1.938, p < 0.001, and aHR: 1.674, p = 0.001, respectively) were significantly higher in the 1G-DES than in the 2G-DES. However, sirolimus-eluting stent showed similar cumulative incidence of any repeat revascularization compared with zotarolimus-eluting stent and biolimus-eluting stent in both pre-TIMI 0/1 and 2/3 groups. The cumulative incidences of all-cause death, re-MI, and ST were similar between the 1G-DES and 2G-DES groups. In this study, 2G-DES showed better clinical outcomes than 1G-DES concerning MACEs and any repeat revascularization regardless of pre-TIMI. However, more research is needed to support these results.
Highlights
Second-generation drug-eluting stents (2G-DES) have a newly advanced biocompatible polymer compared to first-generation (1G-DES), their comparative results are conflicting [1,2,3]
The prescription rates of clopidogrel, cilostazole, and calcium channel blockers as the discharge medications, more than three diseased vessels, American College of Cardiology/American Heart Association (ACC/AHA) type B1 lesion, multivessel percutaneous coronary intervention (PCI), number of deployed stents, and mean serum creatinine and high-density lipoprotein-cholesterol levels were significantly higher in the 1G-DES (Groups A1 and A2) groups than in the 2G-DES (Groups B1 and B2)
The number of men, number of patients requiring CPR on admission, with dyslipidemia or previous PCI, prescription rates of ticagrelor, prasugrel, and BBs as the discharge medications, patients with single-vessel disease, ACC/AHA type B2 lesions, and culprit-only PCI, number of patients requiring intravascular ultrasound (IVUS), mean triglyceride level, and mean deployed stent diameter were significantly higher in the 2G-DES groups than in the 1G-DES groups
Summary
Second-generation drug-eluting stents (2G-DES) have a newly advanced biocompatible polymer compared to first-generation (1G-DES), their comparative results are conflicting [1,2,3]. Previous studies [4,5] demonstrated that pre-percutaneous coronary intervention (pre-PCI) thrombolysis in myocardial infarction (TIMI) flow grade (pre-TIMI). Was a significant predictor of survival in ST-segment elevation myocardial infarction 4.0/). If the blood supply goes down, remnant oxygen in the ischemic area of the myocardium is disappeared within seconds. Pre-TIMI 0/1 and pre-TIMI 2/3 [7] are apparently different milieu in patients with STEMI. Yildiz et al [8] suggested that the pre-TIMI was closely linked with percentage of patients getting PCI, the use of glycoprotein IIb/IIIa, and stent type. Pre-TIMI can be another significant variable for comparing major clinical outcomes between 1G-DES and
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.