title: Clinical Outcomes of Drug-Eluting Stents vs. Bare-Metal Stents in Acute Myocardial Infarction Patients Under Dialysis - A Nationwide Cohort Study.
abstract: BACKGROUND
  Data on the cardiovascular (CV) outcomes of drug-eluting stents (DES) vs. bare-metal stents (BMS) in patients with acute myocardial infarction (AMI) under dialysis are limited.
  
  
  RESULTS
  We analyzed the data from 42,592 AMI patients in the Taiwan National Health Insurance Research Database between 1 January 2007 and 31 December 2011. A total of 984 AMI patients under dialysis were selected as the study cohort. We evaluated the clinical outcomes by comparing 492 subjects who had DES to 492 matched subjects who had BMS. The primary composite outcomes, which included recurrent MI, coronary revascularization and CV death, were significantly lower in the DES group than in the BMS group (41.7% vs. 47.6%, hazard ratio (HR), 0.77; 95% confidence interval (CI), 0.63-0.92, P=0.005) after mean 1.2 years. The patients who received DES had a lower risk of recurrent MI (HR, 0.63; 95% CI, 0.45-0.90), CV death (HR, 0.74; 95% CI, 0.56-0.98) and all-cause mortality (HR, 0.74; 95% CI, 0.61-0.89) than those who used BMS, but a similar risk of major bleeding (HR, 0.99; 95% CI, 0.69-1.42, P=0.952) and ischemic stroke (HR, 1.15; 95% CI, 0.66-2.01, P=0.631).
  
  
  CONCLUSIONS
  Among AMI patients on dialysis undergoing percutaneous coronary interventions, DES implantation significantly reduced the risk of recurrent MI, CV death and all-cause mortality compared with BMS implantation.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital.
authors.forename: Dong-Yi
authors.initials: DY
authors.lastname: Chen
authors.forename: Chun-Tai
authors.initials: CT
authors.lastname: Mao
authors.forename: Ming-Lung
authors.initials: ML
authors.lastname: Tsai
authors.forename: Ming-Jer
authors.initials: MJ
authors.lastname: Hsieh
authors.forename: Yu-Sheng
authors.initials: YS
authors.lastname: Lin
authors.forename: Wen-Jin
authors.initials: WJ
authors.lastname: Cherng
authors.forename: Ming-Shien
authors.initials: MS
authors.lastname: Wen
authors.forename: Chao-Hung
authors.initials: CH
authors.lastname: Wang
authors.forename: I-Chang
authors.initials: IC
authors.lastname: Hsieh
authors.forename: Ming-Jui
authors.initials: MJ
authors.lastname: Hung
authors.forename: Chun-Chi
authors.initials: CC
authors.lastname: Chen
authors.forename: Tien-Hsing
authors.initials: TH
authors.lastname: Chen
mesh_terms: D000368:Aged; D015331:Cohort Studies; D018572:Disease-Free Survival; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D006435:Renal Dialysis; D012307:Risk Factors; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology