Outcomes After First- Versus Second-Generation Drug-Eluting Stent Thrombosis (from the REAL-ST Registry) - 09/09/20
, Tomohiro Shinozaki, PhD, MPH c, Masanobu Ohya, MD, PhD d, Hiromasa Otake, MD, PhD e, Futoshi Yamanaka, MD f, Hiroki Shiomi, MD, PhD g, Masahiro Natsuaki, MD, PhD h, Gaku Nakazawa, MD, PhD i, Norio Tada, MD, PhD a, Kenji Ando, MD b, Kazushige Kadota, MD d, Shigeru Saito, MD f, Takeshi Kimura, MD, PhD gon behalf of the
REAL-ST Registry Investigators
Highlights |
• | Limited data exist on the comparison of clinical outcomes after first- and second-generation drug-eluting stent (DES) thrombosis. |
• | At 1 year, patients with second-generation DES thrombosis (G2-ST) showed a similar mortality to those with first-generation DES thrombosis (G1-ST; 23.0% vs 22.9%, p = 0.76), highlighting that ST remains a life-threatening complication in the second-generation DES era. |
• | Cumulative 1-year incidence of target lesion revascularization was significantly lower in the G2-ST than in the G1-ST (9.7% vs 17.1%, p = 0.01). |
Résumé |
Limited data exist on the comparison of clinical outcomes after first- and second-generation drug-eluting stent (DES) thrombosis. From the Retrospective Multicenter Registry of Stent Thrombosis (ST) After First- and Second-Generation DES Implantation registry, this study evaluated 655 ST patients (first-generation DES thrombosis [G1-ST], n = 342; second-generation DES thrombosis [G2-ST], n = 313). After propensity score matching, the final study population consisted of 159 matched patients. The primary end point was the cumulative 1-year incidence of mortality. The mortality after G2-ST at 1 year was similar to that after G1-ST (23.0% vs 22.9%, p = 0.76). Also, the G2-ST group showed a significantly lower rate of target lesion revascularization than the G1-ST group (9.7% vs 17.1%, p = 0.01). Risk factors of 1-year mortality included cardiogenic shock or arrest at the time of ST, multivessel ST, left ventricular ejection fraction ≤40%, advanced age, and final thrombolysis in myocardial infarction flow grade ≤2. In conclusion, patients with G2-ST showed a similar 1-year mortality to those with G1-ST, highlighting that ST remains a life-threatening complication in the second-generation DES era.
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| Funding: None. |
Vol 132
P. 52-58 - octobre 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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