Prognostic Analysis of Patients with Acute Myocardial Infarction Undergoing Implantation of Different Stents for the First Time

For patients with acute myocardial infarction scheduled to undergo percutaneous coronary stent implantation, in most cases a drug-eluting stent is recommended as the first choice for treatment. However, there is a lack of research on the effectiveness of bare-metal stents and drug-eluting stents on...

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Autores principales:	Cheng-Chung Cheng, Fang-Han Yu, Pi-Shao Ko, Hsiao-Ting Lin, Wei-Shiang Lin, Shu-Meng Cheng, Sui-Lung Su
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	bare-metal stent drug-eluting stent ST-elevation myocardial infarction non-ST-elevation myocardial infarction major cardiovascular incident Medicine R
Acceso en línea:	https://doaj.org/article/c0da2b0450df4332b9de91b753e14971
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spelling	oai:doaj.org-article:c0da2b0450df4332b9de91b753e149712021-11-11T17:42:54ZPrognostic Analysis of Patients with Acute Myocardial Infarction Undergoing Implantation of Different Stents for the First Time10.3390/jcm102150932077-0383https://doaj.org/article/c0da2b0450df4332b9de91b753e149712021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/5093https://doaj.org/toc/2077-0383For patients with acute myocardial infarction scheduled to undergo percutaneous coronary stent implantation, in most cases a drug-eluting stent is recommended as the first choice for treatment. However, there is a lack of research on the effectiveness of bare-metal stents and drug-eluting stents on patients with different types of myocardial infarction. Our objective was to explore the effects of bare-metal stents and drug-eluting stents on patients with different types of myocardial infarction in terms of major cardiovascular incidents. This retrospective cohort study included 934 patients with myocardial infarction undergoing coronary artery stent implantation for the first time at the cardiac catheter room of the Tri-Service General Hospital in the Neihu District between 2014 and 2018. Patients’ information, including demographic data, laboratory data, cardiac echocardiography results, and angiocardiography results, was collected by reviewing medical records. Cox proportional hazards regression was used to adjust the potential confounding factors, and the adjusted data were then used to compare the correlation between different types of stents and major cardiovascular incidents in patients with ST-elevation myocardial infarction and non-ST-elevation myocardial infarction. After the confounding factors were adjusted, in patients with ST-elevation myocardial infarction receiving a drug-eluting stent compared with those receiving a bare-metal stent, it was found that the mortality risk was lower in terms of all causes of death (Adj-HR = 0.26, 95% CI = 0.14–0.48, <i>p</i> < 0.001) and cardiogenic death (Adj-HR = 0.20, 95% CI = 0.08–0.55, <i>p</i> = 0.002), the risk of non-fatal myocardial infarction was lower (Adj-HR = 0.17, 95% CI = 0.04–0.73, <i>p</i> = 0.017), and there was no difference in the risk of revascularization at the lesion site (Adj-HR = 0.59, 95% CI = 0.24–1.43, <i>p</i> = 0.243). It terms of the findings in patients with non-ST-elevation myocardial infarction, those receiving a drug-eluting stent had a lower risk of revascularization at the lesion site (Adj-HR = 0.48, 95% CI = 0.24–0.97, <i>p</i> = 0.04); however, there was no difference in the mortality risk in terms of all causes of death (Adj-HR = 0.71, 95% CI = 0.37–1.35, <i>p</i> = 0.296) or cardiogenic death (Adj-HR = 0.59, 95% CI = 0.18–1.90, <i>p</i> = 0.379),or in the risk of non-fatal myocardial infarction (Adj-HR = 0.27, 95% CI = 0.06–1.25, <i>p</i> = 0.093). Compared with bare-metal stents, drug-eluting stents provide better protection against death to receivers with ST-elevation myocardial infarction; however, this protection is decreased in receivers with non-ST-elevation myocardial infarction. It is recommended that for patients with non-ST-elevation myocardial infarction who are indicated to receive a drug-eluting stent, the clinical effectiveness of the treatment must be considered.Cheng-Chung ChengFang-Han YuPi-Shao KoHsiao-Ting LinWei-Shiang LinShu-Meng ChengSui-Lung SuMDPI AGarticlebare-metal stentdrug-eluting stentST-elevation myocardial infarctionnon-ST-elevation myocardial infarctionmajor cardiovascular incidentMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5093, p 5093 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	bare-metal stent drug-eluting stent ST-elevation myocardial infarction non-ST-elevation myocardial infarction major cardiovascular incident Medicine R
spellingShingle	bare-metal stent drug-eluting stent ST-elevation myocardial infarction non-ST-elevation myocardial infarction major cardiovascular incident Medicine R Cheng-Chung Cheng Fang-Han Yu Pi-Shao Ko Hsiao-Ting Lin Wei-Shiang Lin Shu-Meng Cheng Sui-Lung Su Prognostic Analysis of Patients with Acute Myocardial Infarction Undergoing Implantation of Different Stents for the First Time
description	For patients with acute myocardial infarction scheduled to undergo percutaneous coronary stent implantation, in most cases a drug-eluting stent is recommended as the first choice for treatment. However, there is a lack of research on the effectiveness of bare-metal stents and drug-eluting stents on patients with different types of myocardial infarction. Our objective was to explore the effects of bare-metal stents and drug-eluting stents on patients with different types of myocardial infarction in terms of major cardiovascular incidents. This retrospective cohort study included 934 patients with myocardial infarction undergoing coronary artery stent implantation for the first time at the cardiac catheter room of the Tri-Service General Hospital in the Neihu District between 2014 and 2018. Patients’ information, including demographic data, laboratory data, cardiac echocardiography results, and angiocardiography results, was collected by reviewing medical records. Cox proportional hazards regression was used to adjust the potential confounding factors, and the adjusted data were then used to compare the correlation between different types of stents and major cardiovascular incidents in patients with ST-elevation myocardial infarction and non-ST-elevation myocardial infarction. After the confounding factors were adjusted, in patients with ST-elevation myocardial infarction receiving a drug-eluting stent compared with those receiving a bare-metal stent, it was found that the mortality risk was lower in terms of all causes of death (Adj-HR = 0.26, 95% CI = 0.14–0.48, <i>p</i> < 0.001) and cardiogenic death (Adj-HR = 0.20, 95% CI = 0.08–0.55, <i>p</i> = 0.002), the risk of non-fatal myocardial infarction was lower (Adj-HR = 0.17, 95% CI = 0.04–0.73, <i>p</i> = 0.017), and there was no difference in the risk of revascularization at the lesion site (Adj-HR = 0.59, 95% CI = 0.24–1.43, <i>p</i> = 0.243). It terms of the findings in patients with non-ST-elevation myocardial infarction, those receiving a drug-eluting stent had a lower risk of revascularization at the lesion site (Adj-HR = 0.48, 95% CI = 0.24–0.97, <i>p</i> = 0.04); however, there was no difference in the mortality risk in terms of all causes of death (Adj-HR = 0.71, 95% CI = 0.37–1.35, <i>p</i> = 0.296) or cardiogenic death (Adj-HR = 0.59, 95% CI = 0.18–1.90, <i>p</i> = 0.379),or in the risk of non-fatal myocardial infarction (Adj-HR = 0.27, 95% CI = 0.06–1.25, <i>p</i> = 0.093). Compared with bare-metal stents, drug-eluting stents provide better protection against death to receivers with ST-elevation myocardial infarction; however, this protection is decreased in receivers with non-ST-elevation myocardial infarction. It is recommended that for patients with non-ST-elevation myocardial infarction who are indicated to receive a drug-eluting stent, the clinical effectiveness of the treatment must be considered.
format	article
author	Cheng-Chung Cheng Fang-Han Yu Pi-Shao Ko Hsiao-Ting Lin Wei-Shiang Lin Shu-Meng Cheng Sui-Lung Su
author_facet	Cheng-Chung Cheng Fang-Han Yu Pi-Shao Ko Hsiao-Ting Lin Wei-Shiang Lin Shu-Meng Cheng Sui-Lung Su
author_sort	Cheng-Chung Cheng
title	Prognostic Analysis of Patients with Acute Myocardial Infarction Undergoing Implantation of Different Stents for the First Time
title_short	Prognostic Analysis of Patients with Acute Myocardial Infarction Undergoing Implantation of Different Stents for the First Time
title_full	Prognostic Analysis of Patients with Acute Myocardial Infarction Undergoing Implantation of Different Stents for the First Time
title_fullStr	Prognostic Analysis of Patients with Acute Myocardial Infarction Undergoing Implantation of Different Stents for the First Time
title_full_unstemmed	Prognostic Analysis of Patients with Acute Myocardial Infarction Undergoing Implantation of Different Stents for the First Time
title_sort	prognostic analysis of patients with acute myocardial infarction undergoing implantation of different stents for the first time
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/c0da2b0450df4332b9de91b753e14971
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Prognostic Analysis of Patients with Acute Myocardial Infarction Undergoing Implantation of Different Stents for the First Time

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