TY - JOUR
T1 - Drug-eluting stents versus bare-metal stents in acute myocardial infarction with cardiogenic shock
AU - Ledwoch, Jakob
AU - Fuernau, Georg
AU - Desch, Steffen
AU - Eitel, Ingo
AU - Jung, Christian
AU - De Waha, Suzanne
AU - Poess, Janine
AU - Schneider, Steffen
AU - Schuler, Gerhard
AU - Werdan, Karl
AU - Zeymer, Uwe
AU - Thiele, Holger
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Objectives The aim of the present study was to assess the outcome of patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) receiving drug-eluting stents (DES) compared with bare-metal stents (BMS). Data comparing these two stent technologies in AMI with CS were limited. Methods A total of 783 patients with AMI and CS undergoing early revascularisation were included in the randomised Intra-aortic Balloon Pump in Cardiogenic Shock II trial (n=600) and the associated registry (n=183). Patients receiving no stent or both, DES and BMS, were excluded. Primary end point was the composite of 1-year mortality or re-AMI. Results Of the total cohort, 652 (83%) patients received either solely DES or BMS and were included in the present analysis. Of these, 276 (42%) patients received DES and 376 (58%) received BMS. After adjustment for baseline characteristics, there was no significant difference between DES and BMS regarding the primary end point (HR 0.83 (CI 0.64 to 1.06); p=0.14). There was an independent association of BMS use with older age, atrial fibrillation and coronary single-vessel disease. DES use was associated with prior known dyslipidaemia, baseline haemoglobin level, anterior AMI and treatment at frequently enrolling centres. Conclusions Despite the frequent use of DES nowadays, a substantial number of patients were treated by BMS in AMI complicated by CS. After adjustment for risk factors, the 1-year outcome of patients treated by DES compared with BMS was similar. Trial registrationnumber www.clinicaltrials.gov: NCT00491036.
AB - Objectives The aim of the present study was to assess the outcome of patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) receiving drug-eluting stents (DES) compared with bare-metal stents (BMS). Data comparing these two stent technologies in AMI with CS were limited. Methods A total of 783 patients with AMI and CS undergoing early revascularisation were included in the randomised Intra-aortic Balloon Pump in Cardiogenic Shock II trial (n=600) and the associated registry (n=183). Patients receiving no stent or both, DES and BMS, were excluded. Primary end point was the composite of 1-year mortality or re-AMI. Results Of the total cohort, 652 (83%) patients received either solely DES or BMS and were included in the present analysis. Of these, 276 (42%) patients received DES and 376 (58%) received BMS. After adjustment for baseline characteristics, there was no significant difference between DES and BMS regarding the primary end point (HR 0.83 (CI 0.64 to 1.06); p=0.14). There was an independent association of BMS use with older age, atrial fibrillation and coronary single-vessel disease. DES use was associated with prior known dyslipidaemia, baseline haemoglobin level, anterior AMI and treatment at frequently enrolling centres. Conclusions Despite the frequent use of DES nowadays, a substantial number of patients were treated by BMS in AMI complicated by CS. After adjustment for risk factors, the 1-year outcome of patients treated by DES compared with BMS was similar. Trial registrationnumber www.clinicaltrials.gov: NCT00491036.
UR - http://www.scopus.com/inward/record.url?scp=85024492545&partnerID=8YFLogxK
U2 - 10.1136/heartjnl-2016-310403
DO - 10.1136/heartjnl-2016-310403
M3 - Journal articles
C2 - 28174212
AN - SCOPUS:85024492545
SN - 1355-6037
VL - 103
SP - 1177
EP - 1184
JO - Heart
JF - Heart
IS - 15
ER -
