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Comparison of First- and Second-Generation Drug-Eluting Stents in Patients with Acute Myocardial Infarction and

Yong Hoon Kim1, Ae-Young Her1, Myung Ho Jeong2

  • 1Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Republic of Korea.

Journal of Interventional Cardiology
|August 1, 2020
PubMed

Insights

Second-generation drug-eluting stents (2G-DES) show improved efficacy over first-generation DES (1G-DES) in patients with acute myocardial infarction and prediabetes. This study found 2G-DES significantly reduced major adverse events compared to 1G-DES.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Diabetes Mellitus Research

Background:

  • Prediabetes is linked to increased coronary artery disease risk.
  • The comparative effectiveness of first-generation (1G) and second-generation (2G) drug-eluting stents (DES) in patients with acute myocardial infarction (AMI) and prediabetes remains unclear.

Purpose of the Study:

  • To compare clinical outcomes between 1G-DES and 2G-DES in patients with AMI and prediabetes.
  • To evaluate the safety and efficacy of different DES generations in this specific patient population.

Main Methods:

  • A cohort of 4997 patients with AMI and prediabetes were analyzed.
  • Patients received either 1G-DES (n=726) or 2G-DES (n=4271).
  • Propensity score-matching created comparable groups (698 pairs) to assess patient-oriented composite outcomes (POCOs), including death, recurrent MI, and revascularization, plus stent thrombosis (ST) at 2-year follow-up.

Main Results:

  • After PSM, 1G-DES use was associated with significantly higher rates of POCOs (HR: 1.467), any revascularization (HR: 2.259), and stent thrombosis (HR: 4.361) compared to 2G-DES.
  • No significant differences were observed in all-cause death, cardiac death, or recurrent MI between the groups.

Conclusions:

  • Second-generation DES implantation demonstrates superior efficacy compared to first-generation DES in patients with AMI and prediabetes over a 2-year period.
  • Further research is warranted to validate these findings and guide clinical practice.
Abstract

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