Three-Year Clinical Outcomes With the Cilotax Dual Drug-Eluting Stent vs Everolimus-Eluting Stents in Patients With...

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Biomaterials Science

Background:

• Acute myocardial infarction (AMI) management involves percutaneous coronary intervention (PCI) with drug-eluting stents (DES).
• Comparing the safety and effectiveness of novel DES, such as paclitaxel/cilostazol-eluting Cilotax stents, with established DES is crucial for clinical practice.
• Real-world data provides valuable insights into stent performance in diverse patient populations.

Purpose of the Study:

• To compare the 3-year safety and effectiveness of Cilotax stents versus everolimus-eluting stents in patients with AMI.
• To evaluate key clinical endpoints including target lesion failure, major adverse cardiovascular events (MACE), target vessel revascularization (TVR), and stent thrombosis.

Main Methods:

• A retrospective analysis of 5,472 patients with AMI undergoing PCI using Cilotax (n=212) or everolimus-eluting stents (n=5,260) from the Korea AMI Registry.
• Propensity score matching (PSM) was employed to create balanced groups (Cilotax n=180, everolimus-eluting stents n=170) to minimize confounding factors.
• Clinical outcomes including target lesion failure, MACE, TVR, and stent thrombosis were assessed over a 3-year follow-up period.

Main Results:

• Before PSM, the Cilotax group exhibited significantly higher rates of MACE, myocardial infarction, target lesion revascularization, target vessel revascularization, and stent thrombosis compared to the everolimus-eluting stent group.
• Even after PSM, the Cilotax group continued to show trends towards higher rates of target lesion revascularization and stent thrombosis, although statistical significance varied.
• Specific adverse event rates (e.g., MACE, MI, TVR, stent thrombosis) were notably elevated in the Cilotax group across both pre- and post-matching analyses.

Conclusions:

• The Cilotax stent demonstrated inferior safety and effectiveness compared to everolimus-eluting stents in patients with acute myocardial infarction.
• Higher rates of target lesion revascularization and stent thrombosis were observed with Cilotax stent use.
• The study recommends avoiding the Cilotax dual drug-eluting stent in the treatment of myocardial infarction based on these findings.