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Coronary Stents in Patients with ST-Elevation Myocardial Infarction and Chronic Kidney Disease Undergoing Primary

Khurshid Ahmed1, Myung Ho Jeong, Rabin Chakraborty

  • 1The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea. ; Apollo Gleneagles Hospital, Kolkata, India.

Korean Circulation Journal
|January 17, 2013
PubMed

Insights

For patients with ST-elevation myocardial infarction and chronic kidney disease undergoing percutaneous coronary intervention, all five stent types showed similar 12-month risks for major adverse cardiac events. Further long-term studies are needed to confirm these findings.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Chronic kidney disease (CKD) is linked to adverse outcomes following percutaneous coronary intervention (PCI).
  • Optimal stent selection in STEMI patients with CKD remains an area of investigation.

Purpose of the Study:

  • To compare the efficacy and safety of five different coronary stent types in patients with ST-elevation myocardial infarction (STEMI) and CKD undergoing primary PCI.
  • To evaluate the 12-month incidence of major adverse cardiac events (MACE) across different stent categories.

Main Methods:

  • A cohort of 2408 STEMI patients with CKD (eGFR <60 mL/min/1.73 m²) undergoing primary PCI were analyzed.
  • Patients were stratified into five groups based on stent type: bare metal stent (BMS), paclitaxel-eluting stent (PES), sirolimus-eluting stent (SES), zotarolimus-eluting stent (ZES), and everolimus-eluting stent (EES).
  • The primary endpoint was the occurrence of MACE at 12 months post-procedure.

Main Results:

  • No significant differences were observed in myocardial infarction or target lesion/vessel revascularization rates among the stent groups.
  • However, significant differences were noted in the overall rate of repeat revascularization and all-cause death.
  • The 12-month MACE incidence varied: BMS (8.3%), PES (9.8%), SES (8.6%), ZES (5.5%), and EES (2.6%).
  • Kaplan-Meier analysis and adjusted models did not reveal significant differences in 12-month MACE-free survival among the groups.

Conclusions:

  • The study suggests that any of the five evaluated stent types may be suitable for STEMI patients with CKD undergoing primary PCI, with similar 12-month MACE risk.
  • These findings are hypothesis-generating and underscore the need for long-term randomized trials to validate the comparative effectiveness of these stents in this high-risk population.
Abstract

Keywords:
AngioplastyKidney failure, chronicMyocardial infarctionStents

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