title: Comparison of drug-eluting stents in acute myocardial infarction patients with chronic kidney disease.
abstract: OBJECTIVE
  To determine which drug-eluting stents are more effective in acute myocardial infarction (MI) patients with chronic kidney disease (CKD).
  
  
  METHODS
  This study included a total of 3,566 acute MI survivors with CKD from the Korea Acute Myocardial Infarction Registry who were treated with stenting and followed up for 12 months: 1,845 patients who received sirolimus-eluting stents (SES), 1,356 who received paclitaxel-eluting stents (PES), and 365 who received zotarolimus-eluting stents (ZES). CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m(2) calculated by the modification of diet in renal disease method.
  
  
  RESULTS
  At the 12-month follow-up, patients receiving ZES demonstrated a higher incidence (14.8%) of major adverse cardiac events (MACEs) compared to those receiving SES (10.1%) and PES (12%, p = 0.019). The ZES patients also had a higher incidence (3.9%) of target lesion revascularization (TLR) compared to those receiving SES (1.5%) and PES (2.4%, p = 0.011). After adjusting for confounding factors, ZES was associated with a higher incidence of MACE and TLR than SES (adjusted hazard ratio [HR], 0.623; 95% confidence interval [CI], 0.442 to 0.879; p = 0.007; adjusted HR, 0.350; 95% CI, 0.165 to 0.743; p = 0.006, respectively), and with a higher rate of TLR than PES (adjusted HR, 0.471; 95% CI, 0.223 to 0.997; p = 0.049).
  
  
  CONCLUSIONS
  Our findings suggest that ZES is less effective than SES and PES in terms of 12-month TLR, and has a higher incidence of MACE due to a higher TLR rate compared with SES, in acute MI patients with CKD.
authors.affiliation: Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hachinohe
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saito
authors.forename: Min Chol
authors.initials: MC
authors.lastname: Kim
authors.forename: Kyung Hoon
authors.initials: KH
authors.lastname: Cho
authors.forename: Khurshid
authors.initials: K
authors.lastname: Ahmed
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Hwang
authors.forename: Min Goo
authors.initials: MG
authors.lastname: Lee
authors.forename: Doo Sun
authors.initials: DS
authors.lastname: Sim
authors.forename: Keun-Ho
authors.initials: KH
authors.lastname: Park
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.forename: Jung Chaee
authors.initials: JC
authors.lastname: Kang
authors.forename: Jong Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Shung Chull
authors.initials: SC
authors.lastname: Chae
authors.forename: Young Jo
authors.initials: YJ
authors.lastname: Kim
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Hur
authors.forename: In Whan
authors.initials: IW
authors.lastname: Seong
authors.forename: Taek Jong
authors.initials: TJ
authors.lastname: Hong
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.forename: Myeong Chan
authors.initials: MC
authors.lastname: Cho
authors.forename: Chong Jin
authors.initials: CJ
authors.lastname: Kim
authors.forename: Ki Bae
authors.initials: KB
authors.lastname: Seung
authors.forename: Wook Sung
authors.initials: WS
authors.lastname: Chung
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Jang
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Rha
authors.forename: Jang Ho
authors.initials: JH
authors.lastname: Bae
authors.forename: Seung Jung
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000368:Aged; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D017239:Paclitaxel / Q000008:administration & dosage; D011446:Prospective Studies; D012042:Registries; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D056910:Republic of Korea / Q000453:epidemiology; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: C489443:zotarolimus; D017239:Paclitaxel; D020123:Sirolimus