title: Coronary Stents in Patients with ST-Elevation Myocardial Infarction and Chronic Kidney Disease Undergoing Primary Percutaneous Coronary Intervention.
abstract: OBJECTIVE
  Chronic kidney disease (CKD) is associated with poor outcomes after percutaneous coronary intervention (PCI). We sought to compare different coronary stents used during primary PCI in patients with ST-elevation myocardial infarction (STEMI) and CKD.
  
  
  METHODS
  We selected 2408 consecutive STEMI patients with CKD (estimated glomerular filtration rate <60 mL/min/1.73 m(2)) undergoing primary PCI and divided them into 5 groups based on the type of stent implanted: 1) bare metal stent (BMS), 2) paclitaxel-eluting stent (PES), 3) sirolimus-eluting stent (SES), 4) zotarolimus-eluting stent (ZES), or 5) everolimus-eluting stent (EES). The study endpoint was the number of major adverse cardiac events (MACE) at 12 months.
  
  
  RESULTS
  There was no significant difference in the incidence of 12-month myocardial infarction, target lesion revascularization, or target vessel revascularization between stent groups; however, the overall rate of repeat revascularization differed significantly between groups. All-cause death differed significantly among the groups. The incidence of 12-month MACE in BMS, PES, SES, ZES, and EES was 8.3%, 9.8%, 8.6%, 5.5%, and 2.6%, respectively (p<0.001). Kaplan-Meier analysis did not show a significant differences in 12-month MACE-free survival among the groups (log-rank p=0.076). This finding remained the same after adjusting for multiple confounders (p=0.147).
  
  
  CONCLUSIONS
  Any of the 5 stents can be used to treat STEMI patients with CKD undergoing primary PCI; all have similar risk of 12-month MACE. This result is hypothesis-generating and warrants further evaluation with a long-term randomized study.
authors: The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea. ; Apollo Gleneagles Hospital, Kolkata, India.
authors: Khurshid
authors: K
authors: Ahmed
authors: Myung Ho
authors: MH
authors: Jeong
authors: Rabin
authors: R
authors: Chakraborty
authors: Sumera
authors: S
authors: Ahmed
authors: Young Joon
authors: YJ
authors: Hong
authors: Doo Sun
authors: DS
authors: Sim
authors: Keun Ho
authors: KH
authors: Park
authors: Ju Han
authors: JH
authors: Kim
authors: Youngkeun
authors: Y
authors: Ahn
authors: Jung Chaee
authors: JC
authors: Kang
authors: Myeong Chan
authors: MC
authors: Cho
authors: Chong Jin
authors: CJ
authors: Kim
authors: Young Jo
authors: YJ
authors: Kim
keywords: Angioplasty; Kidney failure, chronic; Myocardial infarction; Stents