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Incidence of periprocedural myocardial infarction following stent implantation: Comparison between first‐ and second‐generation drug‐eluting stents
Author(s) -
Tandjung Kenneth,
Basalus Mounir W.Z.,
Muurman Esther,
Louwerenburg Hans W.,
van Houwelingen K. Gert,
Stoel Martin G.,
de Man Frits H.A.F.,
Jansen Hanneke,
Huisman Jennifer,
Linssen Gerard C.M.,
Droste Herman T.,
Nienhuis Mark B.,
von Birgelen Clemens
Publication year - 2011
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.23334
Subject(s) - medicine , incidence (geometry) , myocardial infarction , stent , percutaneous coronary intervention , cardiology , first generation , percutaneous , drug eluting stent , acute coronary syndrome , conventional pci , surgery , population , physics , environmental health , optics
Background : First‐ and second‐generation drug‐eluting stents (DES) differ in coating materials, which may influence the incidence of periprocedural myocardial infarction (PMI). Objective : To compare the incidence of PMI between first‐ and second‐generation DES, using the current Academic Research Consortium (ARC) definition of PMI. Methods : We assessed 800 patients treated with first‐ (Taxus Liberté or Endeavor) or second‐generation DES (Xience V or Resolute). Each DES group consisted of 200 consecutive patients, who were treated during the transition from first‐ to second‐generation DES. Routine peri‐interventional assessment of cardiac biomarkers was performed to compare the incidence of PMI between DES groups according to the updated definition by the ARC: 2x upper reference limit of creatine kinase (CK), confirmed by CK‐MB elevation. Results : In 800 patients, a total of 1,522 DES (363 Taxus; 385 Endeavor; 382 Xience V; 392 Resolute) were implanted to treat 1,232 lesions. Patient characteristics did not differ between groups. In patients receiving second‐generation DES, more multivessel percutaneous coronary interventions were performed ( P = 0.01). The overall incidence of PMI was 4.75%. Between first‐ and second‐generation DES, there was no significant difference in PMI (5.5% vs. 4.0%; P = 0.29). In a multivariate analysis, only the total number of stents implanted ( P < 0.001) and presentation with acute coronary syndrome ( P = 0.02) were independent predictors of PMI. Conclusion : Using the revised ARC definition, we found no significant difference in PMI between first‐ and second‐generation DES. Overall, PMI occurred in 4.75%, which is 58% lower than with use of the historical PMI definition. © 2011 Wiley Periodicals, Inc.