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To investigate the cardiovascular (CV) outcomes of second-generation limus-eluting stents (LESs) versus paclitaxel-eluting stents (PESs) in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS).
Data from the Taiwan National Health Insurance Research Database was analyzed between January 1, 2007 and December 31, 2011. A total of 573 AMI patients in CS were selected as the study cohort. Propensity score matching (PSM) was conducted to balance covariates across the two groups. The clinical outcomes were evaluated by comparing 191 subjects who used second-generation LESs to 382 matched subjects who used PESs.
The risk of the primary composite outcome (i.e. myocardial infarction, coronary revascularization, and CV death) was significantly lower in the Second-generation LES group compared with the PES group [32.7% vs. 47.6%, hazard ratio (HR), 0.72; 95% CI, 0.55–0.94] at 12-month follow-up. The patients who received Second-generation LESs had a lower risk of coronary revascularization (HR, 0.54; 95% CI, 0.37–0.79) than those who used PESs. However, the risks of myocardial infarction (HR, 0.62; 95% CI, 0.30–1.31), ischemic stroke (HR, 0.62; 95% CI, 0.20–1.94), or CV death (HR, 0.99; 95% CI, 0.67–1.47) were similar between the two groups.
Among patients with CS complicating AMI, second-generation LES implantation significantly reduced the risk of coronary revascularization and composite CV events compared to PES implantation at 12-month follow-up.