One-year clinical outcomes of everolimus-versus sirolimus-eluting stents in patients with acute myocardial infarction

Background: In contrast to many studies comparing everolimus-eluting stent (EES) with paclitaxel-eluting stent (PES), data directly comparing EES with sirolimus-eluting stent (SES) are limited, especially in patients with acute myocardial infarction (AMI).

Methods: This study includes 2911 AMI patients treated with SES (n= 1264) or EES (n= 1701) in Korea Acute Myocardial Infarction Registry (KAMIR). Propensity scorematching was applied to adjust for baseline imbalance in clinical and angiographic characteristics, yielding a total of 2400 well-matched patients (1200 receiving SES and 1200 receiving EES). One-year clinical outcomeswere compared between the two propensity scorematched groups.

Results: Baseline clinical and angiographic characteristics were similar between the two propensity score matched groups. One-year clinical outcomes of the propensity score matched cohort were comparable between the EES versus the SES groups including the rates of cardiac death (4.8% vs. 4.8%, P= 1.000), recurrent myocardial infarction (1.4% vs. 1.7%, P= 0.619), target lesion revascularization (1.4% vs. 1.6%, P= 0.737), target lesion failure (7.0% vs. 7.3%, P= 0.752), and probable or definite stent thrombosis (0.5% vs. 0.9%, P= 0.224) except for a trend toward lower incidence of target vessel revascularization (1.9% vs. 3.0%, P= 0.087) and a lower rate of total major adverse cardiac events (9.3% vs. 11.9%, P = 0.034) in the EES group.

Conclusions: The present propensity scorematched analysis performed in a large-scale, prospective, multicenter registry suggests that the second-generation drug-eluting stent EES has at least comparable or even better safety and efficacy profiles as compared with SES in the setting of AMI.