Background and Objectives: Data on the long-term performance of 2nd -generation drug-eluting stents in STEMI is limited. We sought to compare the outcome of 2nd generation vs. 1st generation DES in this setting.
Methods: We analyzed 459 consecutive patients presenting to our hospital with STEMI and underwent primary percutaneous coronary intervention. Patients were divided into two groups, one in which 1st generation DES [(DES-1)- CYPHER, TAXUS] was used and the second in which 2nd generation DES (DES-2). We evaluated the 1-year and 2-years outcome after the index procedure.
Results: Patients belonging to DES-1 group tended to have higher rates of renal failure (13% vs. 7%, p=0.06) and killip class >1 (10% vs. 5%, p=0.06). Patients belonging to the DES-2 group had higher rates of thrombus aspirations (44% vs. 5%,p=0.001) and final TIMI-3.0 flow (99% vs. 94%,p=0.007). 1-year and 2-years outcome was similar in both groups. (see table).
Stent thrombosis rates in the time period between one and 2-years after procedure were similar (2% in DES-1, 0.8% in DES-2, p=0.8).
Conclusions: In patients presenting with STEMI, despite better angiographic results, 2nd generation DES have similar efficacy and safety as 1st generation DES.
|
1 Year
|
DES 1
(n=157)
|
DES 2
(n=217)
|
p-Value
|
|
Death (%)
|
3.2
|
1.8
|
0.4
|
|
Myocardial Infarction (%)
|
0.6
|
1.9
|
0.3
|
|
Target Vessel Revascularization (%)
|
4.5
|
3.9
|
0.8
|
|
Stent Thrombosis (%)
|
0.6
|
0.5
|
0.8
|
|
MACE (%)
|
9.6
|
0.8
|
0.3
|
|
2 Years
|
DES 1
(n=157)
|
DES 2
(n=135)
|
p-Value
|
|
Death (%)
|
3.2
|
3.7
|
0.8
|
|
Myocardial Infarction (%)
|
3.2
|
3.8
|
0.8
|
|
Stent Thrombosis (%)
|
2.6
|
1.6
|
0.6
|
|
Target Vessel Revascularization (%)
|
8.9
|
8.5
|
0.9
|
|
MACE (%)
|
14
|
14
|
1.0
|
