Procedure-related myonecrosis after bare and drug-eluting stent implantation.
We sought to compare the incidence of myonecrosis after elective implantation of bare metal stents with that of drug-eluting stents. The data of stable patients who were treated with stenting in a single native coronary artery were analyzed retrospectively. The stents used were bare metal in 119, sirolimus-eluting (Cypher Select Plus) in 119 patients, paclitaxel-eluting (Taxus Liberté) in 120, zotarolimus-eluting (Endeavor Sprint) in 122, and everolimus-eluting (Xience V) in 72. Endpoints included post-procedural myonecrosis (any elevation of creatine kinase-MB), myocardial infarction (creatine kinase-MB>3 times the upper limit of normal), and large myocardial infarction (creatine kinase-MB>5 times the upper limit of normal). The incidences of myonecrosis (16.7%-18.9%), myocardial infarction (3.3%-8.4%), and large myocardial infarction (1.7%-5.6%) were not significantly different among stent types. At the 30-day follow-up, there were 2 deaths in patients who had Taxus Liberté stents, one death each in those with Xience V and bare metal stents, and no cases of stroke or target vessel revascularization. In this study, bare metal stents and the 4 drug-eluting stents were associated with similar low incidences of myonecrosis, myocardial infarction, and large myocardial infarction.
Lee
Chi-Hang
CH
Cardiac Department, National University Heart Center, 5 Lower Kent Ridge Road, Singapore. mdclchr@nus.edu.sg
Tse
Hung-Fat
HF
Tai
Bee-Choo
BC
Chen
Zhaojin
Z
Chan
Mark Y
MY
Tan
Huay-Cheem
HC
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D052279:Creatine Kinase, MB Form / Q000097:blood; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000201:enzymology / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D009206:Myocardium / Q000201:enzymology / Q000473:pathology*; D009336:Necrosis; D017239:Paclitaxel / Q000008:administration & dosage; D011474:Prosthesis Design; D012189:Retrospective Studies; D012846:Singapore; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
D015415:Biomarkers; D002317:Cardiovascular Agents; D008670:Metals; D000068338:Everolimus; D052279:Creatine Kinase, MB Form; C489443:zotarolimus; D017239:Paclitaxel; D020123:Sirolimus