Drug-Eluting Stents versus Bare-Metal Stents in Taiwanese Patients with Acute Coronary Syndrome: An Outcome Report of a Multicenter Registry.
BACKGROUND
The study aims to compare cardiovascular outcomes of using bare-metal stents (BMS) and drug-eluting stents (DES) in patients with acute coronary syndrome (ACS) through analysis of the database from the Taiwan ACS registry. Large domestic studies comparing outcomes of interventional strategies using DES and BMS in a Taiwanese population with ACS are limited.


RESULTS
Collected data regarding characteristics and cardiovascular outcomes from the registry database were compared between the BMS and DES groups. A Cox regression model was used in an unadjusted or adjusted manner for analysis. Baseline characteristics apparently varied between DES group (n = 650) and BMS group (n = 1672) such as ACS types, Killip's classifications, or coronary blood flows. Compared with the BMS group, the DES group was associated with significantly lower cumulative incidence of all-cause mortality (3.4% vs. 5.8%, p = 0.008), target vessel revascularization (TVR) (5.2% vs. 7.4%, p = 0.035), or major adverse cardiac events (MACE) (10.2% vs. 15.6%, p < 0.001) at 1 year in a real-world setting. Cox regression analysis showed the BMS group referenced as the DES group had significantly higher risk-adjusted total mortality [hazard ratio (HR) = 1.85, p = 0.026], target vessel revascularization (TVR) (HR = 1.59, p = 0.035), and MACE (HR = 1.68, p = 0.001).


CONCLUSIONS
The data show use of DES over BMS provided advantages to patients with ACS in terms of lower 1-year mortality, TVR, and MACE. The study suggests implantation of DES compared with BMS in Taiwanese patients with ACS is safe and beneficial in the real-world setting.


BACKGROUND
Acute coronary syndrome; Bare-metal stent; Cardiovascular outcome; Drug-eluting stent; Percutaneous coronary intervention.
Cardiovascular Center, Kaohsiung Veterans General Hospital; ; Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung; ; School of Medicine, National Yang-Ming University, Taipei;
Chi-Cheng
CC
Lai
Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital; ; Chang Gung University College of Medicine;
Hon-Kan
HK
Yip
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital; ; Faculty of Medicine, College of Medicine, Kaohsiung Medical University;
Tsung-Hsien
TH
Lin
Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital; ; Chang Gung University College of Medicine;
Chiung-Jen
CJ
Wu
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital; ; Faculty of Medicine, College of Medicine, Kaohsiung Medical University;
Wen-Ter
WT
Lai
School of Medicine, National Yang-Ming University, Taipei; ; Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung;
Chun-Peng
CP
Liu
Division of Biostatistics, Institute of Public Health, National Yang-Ming University, Taipei;
Shu-Chen
SC
Chang
Cardiovascular Center, Kaohsiung Veterans General Hospital; ; College of Health and Nursing, MeiHo University, Pingtung, Taiwan.
Guang-Yuan
GY
Mar