Procedure-related myonecrosis after bare and drug-eluting stent implantation

Asian Cardiovasc Thorac Ann. 2010 Jun;18(3):272-8. doi: 10.1177/0218492310368732.

Abstract

We sought to compare the incidence of myonecrosis after elective implantation of bare metal stents with that of drug-eluting stents. The data of stable patients who were treated with stenting in a single native coronary artery were analyzed retrospectively. The stents used were bare metal in 119, sirolimus-eluting (Cypher Select Plus) in 119 patients, paclitaxel-eluting (Taxus Liberté) in 120, zotarolimus-eluting (Endeavor Sprint) in 122, and everolimus-eluting (Xience V) in 72. Endpoints included post-procedural myonecrosis (any elevation of creatine kinase-MB), myocardial infarction (creatine kinase-MB>3 times the upper limit of normal), and large myocardial infarction (creatine kinase-MB>5 times the upper limit of normal). The incidences of myonecrosis (16.7%-18.9%), myocardial infarction (3.3%-8.4%), and large myocardial infarction (1.7%-5.6%) were not significantly different among stent types. At the 30-day follow-up, there were 2 deaths in patients who had Taxus Liberté stents, one death each in those with Xience V and bare metal stents, and no cases of stroke or target vessel revascularization. In this study, bare metal stents and the 4 drug-eluting stents were associated with similar low incidences of myonecrosis, myocardial infarction, and large myocardial infarction.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary* / adverse effects
  • Angioplasty, Balloon, Coronary* / instrumentation
  • Angioplasty, Balloon, Coronary* / mortality
  • Biomarkers / blood
  • Cardiovascular Agents / administration & dosage*
  • Creatine Kinase, MB Form / blood
  • Drug-Eluting Stents*
  • Everolimus
  • Female
  • Humans
  • Incidence
  • Male
  • Metals*
  • Middle Aged
  • Myocardial Infarction / enzymology
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / etiology*
  • Myocardial Infarction / mortality
  • Myocardial Infarction / pathology
  • Myocardium / enzymology
  • Myocardium / pathology*
  • Necrosis
  • Paclitaxel / administration & dosage
  • Prosthesis Design
  • Retrospective Studies
  • Singapore
  • Sirolimus / administration & dosage
  • Sirolimus / analogs & derivatives
  • Stents*
  • Time Factors
  • Treatment Outcome
  • Up-Regulation

Substances

  • Biomarkers
  • Cardiovascular Agents
  • Metals
  • Everolimus
  • Creatine Kinase, MB Form
  • zotarolimus
  • Paclitaxel
  • Sirolimus