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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
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Safety and Efficacy of Contemporary Drug-Eluting Stents in Patients With ST-Segment Elevation Myocardial Infarction

Oh-Hyun Lee1, Yongcheol Kim1, Nak-Hoon Son2,3

  • 1Yonsei University College of Medicine Cardiovascular Center, Yongin Severance Hospital, Yongin-si, South Korea.

Frontiers in Cardiovascular Medicine
|June 9, 2022
PubMed

Insights

Everolimus-eluting stents (EES) and zotarolimus-eluting stents (ZES) showed similar safety and efficacy in ST-elevation myocardial infarction (STEMI) patients at high ischemic risk. Long-term outcomes were comparable between EES and ZES for STEMI treatment.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Biomedical Engineering

Background:

  • Uncertainty exists regarding the safety and efficacy of drug-eluting stents (DES) in ST-elevation myocardial infarction (STEMI) patients with high ischemic risk.
  • A significant proportion of STEMI patients present with high-risk features requiring careful stent selection.

Purpose of the Study:

  • To compare the clinical outcomes of everolimus-eluting stents (EES) and zotarolimus-eluting stents (ZES) in STEMI patients at high risk of ischemic events.
  • To evaluate the long-term safety and effectiveness of EES versus ZES in this specific patient population.

Main Methods:

  • A prospective, multicenter registry identified 1,592 STEMI patients treated with primary percutaneous coronary intervention (PCI) using either EES or ZES.
  • The primary endpoint was target lesion failure (TLF) at 3 years, a composite of cardiac death, target vessel myocardial infarction (TV-MI), and ischemia-driven target lesion revascularization (ID-TLR).

Main Results:

  • No significant difference in 3-year TLF risk was observed between EES and ZES groups (p = 0.93).
  • Incidences of cardiac death, TV-MI, ID-TLR, and stent thrombosis were similar between the two stent types.
  • Advanced age (>75 years) and left main PCI were identified as independent predictors of TLF.

Conclusions:

  • Both EES and ZES implantation yield comparable clinical outcomes in STEMI patients with high ischemic risk.
  • The choice between EES and ZES does not appear to significantly impact long-term safety or efficacy in this high-risk STEMI cohort.
Abstract

Keywords:
ST-segment elevation myocardial infarctiondrug-eluting stenthigh risk factorpercutaneous coronary intervention (PCI)target lesion failure

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