PMID- 31778370
OWN - NLM
STAT- MEDLINE
DCOM- 20200302
LR  - 20200302
IS  - 1175-8716 (Electronic)
IS  - 0028-8446 (Linking)
VI  - 132
IP  - 1506
DP  - 2019 Nov 8
TI  - Outcomes of patients with ST elevation myocardial infarction in the era of 
      second-generation drug eluting stents; five-year follow-up.
PG  - 34-41
AB  - AIM: The second-generation everolimus and zotarolimus drug eluting stents (DES) 
      have shown superiority for repeat revascularisation and safety to the 
      first-generation devices for stable patients. However, the benefit of those 
      devices in the setting of ST elevation myocardial infarction (STEMI) has remained 
      questionable due to concern regarding stent thrombosis (ST) seen with the 
      first-generation devices. We review the outcomes of patients with STEMI treated 
      in our centre at a time when the second-generation DES became the standard of 
      care. METHODS: All patients who presented to our institution with STEMI and 
      underwent emergency percutaneous intervention (PCI) in 2012 with 
      second-generation DES were identified. Case notes and electronic records were 
      reviewed. Patients undergoing staged PCI to non-culprit lesions were excluded. 
      Patients who died during the primary cardiac event with cardiogenic shock were 
      also excluded. RESULTS: A total of 399 patients (mean age 65+/-12, 274 (76%) 
      male) were identified. Thirty-five patients (8.7%) died during hospitalisation 
      with cardiogenic shock and were excluded from the subsequent analysis. A further 
      35 patients died during follow-up. Patients received a mean of 1.15 DES. Median 
      follow-up time was 4.7 years. Median door to reperfusion time was 90 minutes. The 
      all-cause mortality rate for STEMI survivors was 9.6%. Cardiac mortality rate was 
      3.6%. Thirty-one patients (8.5%) re-presented with symptoms leading to repeat 
      coronary angiography. In-stent restenosis (ISR) was observed only in eight 
      patients (2.2%). The significant factors associated with re-presentation were 
      smoking and medication non-compliance. CONCLUSION: Early mortality rates 
      following emergency PCI for STEMI remain high despite low reperfusion times. The 
      five-year follow-up data would suggest that STEMI survivors have good outcomes 
      with the second-generation DES.
FAU - Alawami, Mohammed
AU  - Alawami M
AD  - Green Lane Cardiovascular Service, Auckland City Hospital, Auckland.
FAU - Sadler, Matthew
AU  - Sadler M
AD  - Cardiology, Auckland City Hospital, Auckland.
FAU - Kasargod, Chethan
AU  - Kasargod C
AD  - Cardiology, Auckland City Hospital, Auckland.
FAU - Watson, Timothy
AU  - Watson T
AD  - Green Lane Cardiovascular Service, Auckland City Hospital, Auckland.
FAU - Webster, Mark
AU  - Webster M
AD  - Green Lane Cardiovascular Service, Auckland City Hospital, Auckland.
FAU - Ruygrok, Peter
AU  - Ruygrok P
AD  - Green Lane Cardiovascular Service, Auckland City Hospital, Auckland.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20191108
PL  - New Zealand
TA  - N Z Med J
JT  - The New Zealand medical journal
JID - 0401067
RN  - 9HW64Q8G6G (Everolimus)
RN  - H4GXR80IZE (zotarolimus)
RN  - W36ZG6FT64 (Sirolimus)
SB  - IM
MH  - Aged
MH  - Cause of Death
MH  - Coronary Angiography
MH  - *Drug-Eluting Stents
MH  - Everolimus/therapeutic use
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - New Zealand
MH  - Percutaneous Coronary Intervention/adverse effects/*methods
MH  - ST Elevation Myocardial Infarction/*mortality/*therapy
MH  - Sirolimus/analogs & derivatives/therapeutic use
MH  - Thrombosis/epidemiology
MH  - Treatment Outcome
COIS- Nil.
EDAT- 2019/11/30 06:00
MHDA- 2020/03/03 06:00
CRDT- 2019/11/29 06:00
PHST- 2019/11/29 06:00 [entrez]
PHST- 2019/11/30 06:00 [pubmed]
PHST- 2020/03/03 06:00 [medline]
PST - epublish
SO  - N Z Med J. 2019 Nov 8;132(1506):34-41.