title: Incidence of periprocedural myocardial infarction following stent implantation: comparison between first- and second-generation drug-eluting stents.
abstract: BACKGROUND
  First- and second-generation drug-eluting stents (DES) differ in coating materials, which may influence the incidence of periprocedural myocardial infarction (PMI).
  
  
  OBJECTIVE
  To compare the incidence of PMI between first- and second-generation DES, using the current Academic Research Consortium (ARC) definition of PMI.
  
  
  METHODS
  We assessed 800 patients treated with first- (Taxus Liberté or Endeavor) or second-generation DES (Xience V or Resolute). Each DES group consisted of 200 consecutive patients, who were treated during the transition from first- to second-generation DES. Routine peri-interventional assessment of cardiac biomarkers was performed to compare the incidence of PMI between DES groups according to the updated definition by the ARC: 2x upper reference limit of creatine kinase (CK), confirmed by CK-MB elevation.
  
  
  RESULTS
  In 800 patients, a total of 1,522 DES (363 Taxus; 385 Endeavor; 382 Xience V; 392 Resolute) were implanted to treat 1,232 lesions. Patient characteristics did not differ between groups. In patients receiving second-generation DES, more multivessel percutaneous coronary interventions were performed (P = 0.01). The overall incidence of PMI was 4.75%. Between first- and second-generation DES, there was no significant difference in PMI (5.5% vs. 4.0%; P = 0.29). In a multivariate analysis, only the total number of stents implanted (P < 0.001) and presentation with acute coronary syndrome (P = 0.02) were independent predictors of PMI.
  
  
  CONCLUSIONS
  Using the revised ARC definition, we found no significant difference in PMI between first- and second-generation DES. Overall, PMI occurred in 4.75%, which is 58% lower than with use of the historical PMI definition.
authors: Department of Cardiology, Thoraxcentrum Twente, Enschede, The Netherlands.
authors: Kenneth
authors: K
authors: Tandjung
authors: Mounir W Z
authors: MW
authors: Basalus
authors: Esther
authors: E
authors: Muurman
authors: Hans W
authors: HW
authors: Louwerenburg
authors: K Gert
authors: KG
authors: van Houwelingen
authors: Martin G
authors: MG
authors: Stoel
authors: Frits H A F
authors: FH
authors: de Man
authors: Hanneke
authors: H
authors: Jansen
authors: Jennifer
authors: J
authors: Huisman
authors: Gerard C M
authors: GC
authors: Linssen
authors: Herman T
authors: HT
authors: Droste
authors: Mark B
authors: MB
authors: Nienhuis
authors: Clemens
authors: C
authors: von Birgelen
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000628:therapy*; D052279:Creatine Kinase, MB Form / Q000097:blood; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology*; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D011474:Prosthesis Design; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D002317:Cardiovascular Agents; D052279:Creatine Kinase, MB Form