Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Circ J. 2013;77(8):2024-31. doi: 10.1253/circj.cj-13-0017. Epub 2013 May 17.
The purpose of the present study was to compare the 5-year clinical outcomes after implantation of drug-eluting stent (DES) and bare-metal stent (BMS) in Japanese patients with acute myocardial infarction (AMI).
This study was a subgroup analysis of the Nagoya Acute Myocardial Infarction Study (NAMIS). It included 658 AMI patients, of which 280 were treated with a DES and 378 with a BMS. The major adverse cardiac event (MACE)-free rates during the 5-year follow-up period were similar between the 2 groups (95.7% vs. 96.8%, P=0.482). A significant difference was seen, however, in the target lesion revascularization (TLR) rates (7.9% vs. 17.7%, P<0.0001). Interestingly, there was no significant difference between the 2 groups from year 1 to 5 with regard to late TLR (2.5% vs. 2.1%, P=0.906), despite the markedly lower incidence of TLR within the first year in the DES group compared with the BMS group (5.4% vs. 15.6%, P<0.0001).
In this long-term follow-up analysis of DES compared to BMS in Japanese patients with AMI, there was no significant difference in the incidence of MACE. Although a lower rate of TLR was observed in DES group within the first year, the superiority of DES in relation to the incidence of TLR disappeared after the first year following primary percutaneous coronary intervention.
本研究旨在比较药物洗脱支架（DES）和裸金属支架（BMS）植入后日本急性心肌梗死（AMI）患者的 5 年临床结局。
本研究是名古屋急性心肌梗死研究（NAMIS）的亚组分析。共纳入 658 例 AMI 患者，其中 280 例接受 DES 治疗，378 例接受 BMS 治疗。5 年随访期间，两组主要不良心脏事件（MACE）无事件生存率相似（95.7% vs. 96.8%，P=0.482）。然而，两组之间的靶病变血运重建（TLR）发生率存在显著差异（7.9% vs. 17.7%，P<0.0001）。有趣的是，DES 组和 BMS 组在第 1 年至第 5 年之间的晚期 TLR 发生率无显著差异（2.5% vs. 2.1%，P=0.906），尽管 DES 组 TLR 发生率在第 1 年明显低于 BMS 组（5.4% vs. 15.6%，P<0.0001）。
在这项 DES 与 BMS 比较的日本 AMI 患者长期随访分析中，MACE 发生率无显著差异。虽然 DES 组在第 1 年内 TLR 发生率较低，但在初次经皮冠状动脉介入治疗后第 1 年之后，DES 组在 TLR 发生率方面的优势消失。
