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원 저급성 심근경색증 환자에서 Everolimus-eluting Stent와 Biolimus-eluting Stent 시술 후 임상 경과
박인철 ( In Cheol Park ),정명호 ( Myung Ho Jeong ),김인수 ( In Soo Kim ),이정애 ( Jung Ae Rhee ),최진수 ( Jin Su Choi ),박인혜 ( In Hyae Park ),채임순 ( Leem Soon Chai ),정윤아 ( Yun Ah Jeong ),현대용 ( Dae Yong Hyun ),정해창 ( Ha 대한내과학회 2015 대한내과학회지 Vol.89 No.4
Background/Aims: We compared the efficacy and safety of the second-generation everolimus-eluting stent (EES) and the third generation biolimus-eluting stent (BES) in patients with acute myocardial infarction (AMI). Methods: We analyzed 629 consecutive patients (mean age 65.1 ± 11.2 years, 426 males) with AMI undergoing percutaneous coronary intervention from February 2008 to April 2012. They were divided into two groups according to stent type (EES group, n = 426; BES group, n = 203). The primary end-point was 2-year major adverse cardiac events (MACEs), defined as the composite of all-cause death, myocardial infarction, target vessel revascularization, non-target vessel revascularization and target lesion revascularization. The secondary end-point was 2-year target lesion failure (TLF). Results: There were no significant differences in baseline characteristics, except that the patients with EES had a significantly higher prevalence of diabetes mellitus (34.7 vs. 22.7%, p = 0.002) and were older (67.1 ± 11.3 vs. 64 ± 12.9 years, p = 0.039) com-pared with the patients with BES. After propensity score matching, 2-year clinical outcomes showed no differences in composite MACEs or TLF between the two groups. Multivariate Cox regression analysis showed that stent type was not a predictor of 2-year mortality or MACEs. However, older age (hazard ratio [HR] 1.037, 95% confidence interval [CI] 1.014-1.060, p = 0.001), diabetes mellitus (HR 2.247, 95% CI 1.426-3.539, p = 0.001) and a left ventricular ejection fraction ≤ 45% (HR 3.007, 95% CI 1.978-4.573, p = 0.001) were independent predictors for 2-year MACEs in patients undergoing EES or BES. Conclusions: Patients with BES had similar clinical 2-year outcomes compared with EES patients with AMI. (Korean J Med 2015;89:418-427)
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