title: Comparison of Resolute zotarolimus-eluting stents versus everolimus-eluting stents in patients with metabolic syndrome and acute myocardial infarction: propensity score-matched analysis.
abstract: BACKGROUND
  Despite common use of second-generation drug-eluting stents in treating patients with coronary artery disease, there is lack of data comparing these stents exclusively in patients with acute myocardial infarction (AMI), especially with metabolic syndrome (MetS), which is highly prevalent in AMI and potential to worsen clinical outcomes. The aim of this study was to compare clinical outcomes of everolimus-eluting stent (EES) and Resolute-zotarolimus-eluting stent (R-ZES) in AMI patients with MetS, in terms of stent-related and patient-related outcomes.
  
  
  METHODS
  A total of 3942 AMI patients in the KAMIR (Korea Acute Myocardial Infarction Registry) were grouped according to the presence of MetS and stent type: EES (N=1582) and R-ZES (N=255) in MetS (1837). Target lesion failure (TLF) and patient-oriented composite events (POCE) at 1 year were evaluated.
  
  
  RESULTS
  In MetS patients, TLF (3.7% vs. 2.7%, p=0.592) and POCE (7.9% vs. 6.7%, p=0.764) were similar between EES and R-ZES. Also in Non-MetS patients, TLF (3.9% vs. 3.1%, p=0.307) and POCE (6.4% vs. 7.3%, p=0.866) were similar between 2 groups. TLF was similar between MetS and Non-MetS patients (3.6% vs. 3.8%), while POCEs (7.7% vs. 6.6%) were higher in MetS. Propensity-score matching analysis showed similar results between stent groups in MetS and Non-MetS. In multivariate analysis, left ventricular ejection fraction and symptom-to-door time were independent predictors of TLF and POCE in MetS patients with AMI.
  
  
  CONCLUSIONS
  In MetS patients with AMI, EES and R-ZES showed excellent performance and safety. However, patient-oriented composite events were relatively high, suggesting more efforts to improve them.
authors.affiliation: Chonnam National University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea.
authors.forename: Mi Seon
authors.initials: MS
authors.lastname: Ji
authors.affiliation: Chonnam National University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea. Electronic address: myungho@chollian.net.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.affiliation: Chonnam National University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea.
authors.forename: Young Keun
authors.initials: YK
authors.lastname: Ahn
authors.affiliation: Chonnam National University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea.
authors.forename: Sang Hyung
authors.initials: SH
authors.lastname: Kim
authors.affiliation: YeungnamUniversityHospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea.
authors.forename: Young Jo
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Kyungpook National University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea.
authors.forename: Shung Chull
authors.initials: SC
authors.lastname: Chae
authors.affiliation: Pusan National University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea.
authors.forename: Taek Jong
authors.initials: TJ
authors.lastname: Hong
authors.affiliation: Chungnam National University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea.
authors.forename: In Whan
authors.initials: IW
authors.lastname: Seong
authors.affiliation: Chonbuk National University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea.
authors.forename: Jei Keon
authors.initials: JK
authors.lastname: Chae
authors.affiliation: Kyung Hee University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea.
authors.forename: Chong Jin
authors.initials: CJ
authors.lastname: Kim
authors.affiliation: Chungbuk National University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea.
authors.forename: Myeong Chan
authors.initials: MC
authors.lastname: Cho
authors.affiliation: Korea University Guro Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea.
authors.forename: Seung-Woon
authors.initials: SW
authors.lastname: Rha
authors.affiliation: Konyang University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea.
authors.forename: Jang Ho
authors.initials: JH
authors.lastname: Bae
authors.affiliation: Catholic University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea.
authors.forename: Ki Bae
authors.initials: KB
authors.lastname: Seung
authors.affiliation: Asan Medical Center, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea.
authors.forename: Seung Jung
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Keimyung University Hospital, Korea Acute Myocardial infarction Registry (KAMIR) Study Group of Korean Circulation Society, Republic of Korea.
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Hur
mesh_terms: D017023:Coronary Angiography; D054855:Drug-Eluting Stents; D004562:Electrocardiography; D000068338:Everolimus / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D057216:Propensity Score; D012042:Registries; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000494:pharmacology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000068338:Everolimus; C489443:zotarolimus; D020123:Sirolimus
keywords: Drug-coated stents; Metabolic cardiovascular syndrome; Myocardial infarction