Drug-eluting versus bare-metal stents for first myocardial infarction in patients with atrial fibrillation: A nationwide population-based cohort study


Autoři: Nen-Chung Chang aff001;  Patrick Hu aff002;  Tien-Hsing Chen aff004;  Chun-Tai Mao aff004;  Ming-Jui Hung aff004;  Chi-Tai Yeh aff005;  Ming-Yow Hung aff007
Působiště autorů: Division of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan aff001;  University of California, Riverside, Riverside, California, United States of America aff002;  Department of Cardiology, Riverside Medical Clinic, Riverside, California, United States of America aff003;  Division of Cardiology, Department of Medicine and Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Chang Gung University College of Medicine, Keelung City, Taiwan aff004;  Department of Medical Research and Education, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan aff005;  Department of Medical Laboratory Science and Biotechnology, Yuanpei University of Medical Technology, Hsinchu City, Taiwan aff006;  Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan aff007;  Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan aff008
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
prolekare.web.journal.doi_sk: 10.1371/journal.pone.0227571

Souhrn

Background

Acute myocardial infarction (AMI) complicates the clinical management of atrial fibrillation (AF) because coronary stenting may influence subsequent antithrombotic therapy. We investigated the use of a bare-metal stent (BMS) or a drug-eluting stent (DES) and associated outcomes in patients with pre-existing AF and first AMI undergoing percutaneous coronary intervention.

Methods and results

Patient records in this population-based study were retrospectively collected from the Taiwan National Health Insurance Research Database. Using propensity score matching (PSM), we used 1:2 ratio stratification into a DES group of 436 and a BMS group of 785 patients from 2007 to 2011. The mean follow-up of matched cohorts was 1.7 years. After PSM, DESs were associated with lower rates of cardiovascular death (7.8%, hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.39–0.86 and 10.1%, HR 0.64, 95% CI 0.45–0.90) and primary composite outcome (35.1%, HR 0.76, 95% CI 0.63–0.92 and 48.2%, HR 0.81, 95% CI 0.69–0.96) than BMSs within the first year and at the end of follow-up. Although the greatest benefit from DESs, irrespective of the first- and second- generation DESs, implantation was observed within the first year only, this benefit was not observed in patients with diabetes, chronic kidney disease, or dialysis.

Conclusions

Use of DESs in AMI patients with pre-existing AF is associated with significantly lower rates of cardiovascular death and primary composite outcome within the first year follow-up. However, the effect is not apparent in patients with diabetes, chronic kidney disease or dialysis.

Klíčová slova:

Anticoagulant therapy – Atrial fibrillation – Coronary stenting – Death rates – Hemorrhage – Myocardial infarction – Revascularization – Stent implantation


Zdroje

1. Soliman EZ, Safford MM, Muntner P, Khodneva Y, Dawood FZ, Zakai NA, et al. Atrial fibrillation and the risk of myocardial infarction. JAMA Intern Med. 2014; 174:107–14. https://doi.org/10.1001/jamainternmed.2013.11912 24190540

2. Al Khdair D, Alshengeiti L, Elbarouni B, Yan RT, Grondin FR, Spencer FA, et al; Global Registry of Acute Coronary Events (GRACE/GRACE2) and the Canadian Registry of Coronary Events (CANRACE) Investigators. Management and outcome of acute coronary syndrome patients in relation to prior history of atrial fibrillation. Can J Cardiol. 2012; 28:443–9. https://doi.org/10.1016/j.cjca.2011.12.011 22439969

3. Violi F, Soliman EZ, Pignatelli P, Pastori D. Atrial Fibrillation and Myocardial Infarction: A Systematic Review and Appraisal of Pathophysiologic Mechanisms. J Am Heart Assoc. 2016; 5:e003347. https://doi.org/10.1161/jaha.116.003347 27208001

4. Goto S, Ikeda Y, Shimada K, Uchiyama S, Origasa H, Kobayashi H; J-TRACE Investigators. One-year cardiovascular event rates in Japanese outpatients with myocardial infarction, stroke, and atrial fibrillation. -Results From the Japan Thrombosis Registry for Atrial Fibrillation, Coronary, or Cerebrovascular Events (J-TRACE). Circ J. 2011; 75:2598–604. https://doi.org/10.1253/circj.cj-11-0378 21857143

5. Aoki J, Lansky AJ, Mehran R, Moses J, Bertrand ME, McLaurin BT, et al. Early stent thrombosis in patients with acute coronary syndromes treated with drug-eluting and bare metal stents: the Acute Catheterization and Urgent Intervention Triage Strategy trial. Circulation. 2009; 119:687–98. https://doi.org/10.1161/circulationaha.108.804203 19171852

6. Mao CT, Chen TH, Tseng CN, Chen SW, Hsieh IC, Hung MJ, et al. Clinical outcomes of second-generation limus-eluting stents compared to paclitaxel-eluting stents for acute myocardial infarction with cardiogenic shock. PLoS One. 2019; 14:e0214417. https://doi.org/10.1371/journal.pone.0214417 30943217

7. Sambola A, Mutuberría M, García Del Blanco B, Alonso A, Barrabés JA, Bueno H, et al. Impact of Triple Therapy in Elderly Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention. PLoS One. 2016; 11:e0147245. https://doi.org/10.1371/journal.pone.0147245 26808678

8. European Heart Rhythm Association; Heart Rhythm Society, Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, et al; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; European Society of Cardiology Committee for Practice Guidelines; Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation—executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation). J Am Coll Cardiol. 2006; 48:854–906. https://doi.org/10.1016/j.jacc.2006.07.009 16904574

9. January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC Jr, et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014; 64:e1–e76. https://doi.org/10.1016/j.jacc.2014.03.022 24685669

10. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016; 37:2893–962. https://doi.org/10.1093/eurheartj/ehw210 27567408

11. Dewilde WJ, Oirbans T, Verheugt FW, Kelder JC, De Smet BJ, Herrman JP, et al; WOEST study investigators. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial. Lancet. 2013; 381:1107–15. https://doi.org/10.1016/S0140-6736(12)62177-1 23415013

12. Braun OÖ, Bico B, Chaudhry U, Wagner H, Koul S, Tydén P, et al. Concomitant use of warfarin and ticagrelor as an alternative to triple antithrombotic therapy after an acute coronary syndrome. Thromb Res. 2015; 135:26–30. https://doi.org/10.1016/j.thromres.2014.10.016 25467434

13. January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE, Cleveland JC Jr, et al. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society in Collaboration With the Society of Thoracic Surgeons. Circulation. 2019; 140:e125–e151. https://doi.org/10.1161/CIR.0000000000000665 30686041

14. Gibson CM, Mehran R, Bode C, Halperin J, Verheugt FW, Wildgoose P, et al. Prevention of Bleeding in Patients with Atrial Fibrillation Undergoing PCI. N Engl J Med. 2016; 375:2423–34. doi: 10.1056/NEJMoa1611594 27959713

15. Cannon CP, Bhatt DL, Oldgren J, Lip GYH, Ellis SG, Kimura T, et al; RE-DUAL PCI Steering Committee and Investigators. Dual Antithrombotic Therapy with Dabigatran after PCI in Atrial Fibrillation. N Engl J Med. 2017; 377:1513–24. doi: 10.1056/NEJMoa1708454 28844193

16. Angiolillo DJ, Goodman SG, Bhatt DL, Eikelboom JW, Price MJ, Moliterno DJ, et al. Antithrombotic Therapy in Patients With Atrial Fibrillation Treated With Oral Anticoagulation Undergoing Percutaneous Coronary Intervention. Circulation. 2018; 138:527–36. https://doi.org/10.1161/CIRCULATIONAHA.118.034722 30571525

17. O’Gara PT, Kushner FG, Ascheim DD, Casey DE Jr, Chung MK, de Lemos JA, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013; 61:e78–e140. https://doi.org/10.1016/j.jacc.2012.11.019 23256914

18. Faxon DP, Eikelboom JW, Berger PB, Holmes DR Jr, Bhatt DL, Moliterno DJ, et al. Antithrombotic therapy in patients with atrial fibrillation undergoing coronary stenting: a North American perspective: executive summary. Circ Cardiovasc Interv. 2011; 4:522–34. https://doi.org/10.1161/CIRCINTERVENTIONS.111.965186 22010191

19. Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, et al; American College of Cardiology Foundation; American Heart Association Task Force on Practice Guidelines; Society for Cardiovascular Angiography and Interventions. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. J Am Coll Cardiol. 2011; 58:e44–122. https://doi.org/10.1016/j.jacc.2011.08.007 22070834

20. Angiolillo DJ, Goodman SG, Bhatt DL, Eikelboom JW, Price MJ, Moliterno DJ, et al. Antithrombotic Therapy in Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention: A North American Perspective-2016 Update. Circ Cardiovasc Interv. 2016; 9. e004395. https://doi.org/10.1161/CIRCINTERVENTIONS.116.004395 27803042

21. Lip GY, Windecker S, Huber K, Kirchhof P, Marin F, Ten Berg JM, et al. Management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous coronary or valve interventions: a joint consensus document of the European Society of Cardiology Working Group on Thrombosis, European Heart Rhythm Association (EHRA), European Association of Percutaneous Cardiovascular Interventions (EAPCI) and European Association of Acute Cardiac Care (ACCA) endorsed by the Heart Rhythm Society (HRS) and Asia-Pacific Heart Rhythm Society (APHRS). Eur Heart J. 2014; 35:3155–79. https://doi.org/10.1093/eurheartj/ehu298 25154388

22. Russ MA, Wackerl C, Zeymer U, Hochadel M, Kerber S, Zahn R, et al; ALKK-Study Group. Gender based differences in drug eluting stent implantation—data from the German ALKK registry suggest underuse of DES in elderly women. BMC Cardiovasc Disord. 2017; 17:68. https://doi.org/10.1186/s12872-017-0500-y 28241861

23. Kim C, Redberg RF, Pavlic T, Eagle KA. A systematic review of gender differences in mortality after coronary artery bypass graft surgery and percutaneous coronary interventions. Clin Cardiol. 2007; 30:491–5. https://doi.org/10.1002/clc.20000 17880013

24. Hsing AW, Ioannidis JP. Nationwide Population Science: Lessons From the Taiwan National Health Insurance Research Database. JAMA Intern Med. 2015; 175:1527–9. https://doi.org/10.1001/jamainternmed.2015.3540 26192815

25. Lin LY, Warren-Gash C, Smeeth L, Chen PC. Data resource profile: the National Health Insurance Research Database (NHIRD). Epidemiol Health. 2018;40:e2018062. https://doi.org/10.4178/epih.e2018062 30727703

26. Hsieh CY, Su CC, Shao SC, Sung SF, Lin SJ, Kao Yang YH, et al. Taiwan’s National Health Insurance Research Database: past and future. Clin Epidemiol. 2019 May 3;11:349–58. https://doi.org/10.2147/CLEP.S196293 31118821

27. Cheng CL, Lee CH, Chen PS, Li YH, Lin SJ, Yang YH. Validation of acute myocardial infarction cases in the national health insurance research database in taiwan. J Epidemiol. 2014; 24:500–7. https://doi.org/10.2188/jea.je20140076 25174915

28. Chen DY, Mao CT, Tsai ML, Chen SW, Lin YS, Hsieh IC, et al. Clinical outcomes of drug-eluting stents versus bare-metal stents in patients with cardiogenic shock complicating acute myocardial infarction. Int J Cardiol. 2016; 215:98–104. https://doi.org/10.1016/j.ijcard.2016.04.014 27111168

29. Hsieh CY, Chen CH, Li CY, Lai ML. Validating the diagnosis of acute ischemic stroke in a National Health Insurance claims database. J Formos Med Assoc. 2015; 114:254–9. https://doi.org/10.1016/j.jfma.2013.09.009 24140108

30. Wu CY, Chen YJ, Ho HJ, Hsu YC, Kuo KN, Wu MS, et al. Association between nucleoside analogues and risk of hepatitis B virus-related hepatocellular carcinoma recurrence following liver resection. JAMA. 2012; 308:1906–14. https://doi.org/10.1001/2012.jama.11975 23162861

31. Hicks KA, Hung HMJ, Mahaffey KW, Mehran R, Nissen SE, Stockbridge NL, et al; for Standardized Data Collection for Cardiovascular Trials Initiative. Standardized Definitions for End Point Events in Cardiovascular Trials. US Food & Drug Administration. 2010.

32. Chen DY, Mao CT, Tsai ML, Hsieh MJ, Lin YS, Cherng WJ, et al. Clinical Outcomes of Drug-Eluting Stents vs. Bare-Metal Stents in Acute Myocardial Infarction Patients Under Dialysis—A Nationwide Cohort Study. Circ J. 2016; 80:363–70. https://doi.org/10.1253/circj.CJ-15-0778 26581755

33. King SB 3rd, Smith SC Jr, Hirshfeld JW Jr, Jacobs AK, Morrison DA, Williams DO; 2005 WRITING COMMITTEE MEMBERS, Feldman TE, Kern MJ, O’Neill WW, Schaff HV, Whitlow PL, Adams CD, Anderson JL, Buller CE, Creager MA, Ettinger SM, Halperin JL, Hunt SA, Krumholz HM, Kushner FG, Lytle BW, Nishimura R, Page RL, Riegel B, Tarkington LG, Yancy CW. 2007 Focused Update of the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: 2007 Writing Group to Review New Evidence and Update the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention, Writing on Behalf of the 2005 Writing Committee. Circulation. 2008; 117:261–95. https://doi.org/10.1161/CIRCULATIONAHA.107.188208 18079354

34. Ellis SG, Stone GW, Cox DA, Hermiller J, O’Shaughnessy C, Mann T, et al, TAXUS IV Investigators. Long-term safety and efficacy with paclitaxel-eluting stents: 5-year final results of the TAXUS IV clinical trial (TAXUS IV-SR: Treatment of De Novo Coronary Disease Using a Single Paclitaxel-Eluting Stent). JACC Cardiovasc Interv. 2009; 2:1248–59. https://doi.org/10.1016/j.jcin.2009.10.003 20129552

35. Lagerqvist B, James SK, Stenestrand U, Lindbäck J, Nilsson T, Wallentin L; SCAAR Study Group. Long-term outcomes with drug-eluting stents versus bare-metal stents in Sweden. N Engl J Med. 2007; 356:1009–19. https://doi.org/10.1056/nejmoa067722 17296822

36. McFadden EP, Stabile E, Regar E, Cheneau E, Ong AT, Kinnaird T, et al. Late thrombosis in drug-eluting coronary stents after discontinuation of antiplatelet therapy. Lancet. 2004; 364:1519–21. https://doi.org/10.1016/s0140-6736(04)17275-9 15500897

37. De Luca G, Dirksen MT, Spaulding C, Kelbaek H, Schalij M, Thuesen L, et al; Drug-Eluting Stent in Primary Angioplasty (DESERT) Cooperation. Drug-eluting vs bare-metal stents in primary angioplasty: a pooled patient-level meta-analysis of randomized trials. Arch Intern Med. 2012; 172:611–21. https://doi.org/10.1001/archinternmed.2012.758 22529227

38. January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC Jr, et al; ACC/AHA Task Force Members. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation. 2014; 130:e199–267. https://doi.org/10.1161/cir.0000000000000041 24682347

39. Authors/Task Force members, Windecker S, Kolh P, Alfonso F, Collet JP, Cremer J, Falk V, et al. 2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J. 2014; 35:2541–619. https://doi.org/10.1093/eurheartj/ehu278 25173339

40. Puurunen MK, Kiviniemi T, Schlitt A, Rubboli A, Dietrich B, Karjalainen P, et al. CHADS2, CHA2DS2-VASc and HAS-BLED as predictors of outcome in patients with atrial fibrillation undergoing percutaneous coronary intervention. Thromb Res. 2014; 133:560–6. https://doi.org/10.1016/j.thromres.2014.01.007 24461143

41. Valgimigli M, Patialiakas A, Thury A, McFadden E, Colangelo S, Campo G, et al; ZEUS Investigators. Zotarolimus-eluting versus bare-metal stents in uncertain drug-eluting stent candidates. J Am Coll Cardiol. 2015; 65:805–15. https://doi.org/10.1016/j.jacc.2014.11.053 25720624

42. Urban P, Meredith IT, Abizaid A, Pocock SJ, Carrié D, Naber C, et al; LEADERS FREE Investigators. Polymer-free Drug-Coated Coronary Stents in Patients at High Bleeding Risk. N Engl J Med. 2015; 373:2038–47. doi: 10.1056/NEJMoa1503943 26466021

43. Varenne O, Cook S, Sideris G, Kedev S, Cuisset T, Carrié D, et al; SENIOR investigators. Drug-eluting stents in elderly patients with coronary artery disease (SENIOR): a randomised single-blind trial. Lancet. 2018; 391:41–50. https://doi.org/10.1016/S0140-6736(17)32713-7 29102362

44. Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med. 2007; 146:857–67. doi: 10.7326/0003-4819-146-12-200706190-00007 17577005

45. Potter BJ, Andò G, Cimmino G, Ladeiras-Lopes R, Frikah Z, Chen XY, et al. Time trends in antithrombotic management of patients with atrial fibrillation treated with coronary stents: Results from TALENT-AF (The internAtionaL stENT—Atrial Fibrillation study) multicenter registry. Clin Cardiol. 2018; 41:470–75. https://doi.org/10.1002/clc.22898 29663443

46. Kikkert WJ, Damman P. Optimal duration of dual antiplatelet therapy for coronary artery disease. Neth Heart J. 2018; 26:321–33. https://doi.org/10.1007/s12471-018-1113-5 29713989

47. Ho KW, Ivanov J, Freixa X, Overgaard CB, Osten MD, Ing D, et al. Antithrombotic therapy after coronary stenting in patients with nonvalvular atrial fibrillation. Can J Cardiol. 2013; 29:213–8. https://doi.org/10.1016/j.cjca.2012.08.008 23089528

48. De Luca G, Dirksen MT, Spaulding C, Kelbæk H, Schalij M, Thuesen L, et al; DESERT cooperation. Impact of diabetes on long-term outcome after primary angioplasty: insights from the DESERT cooperation. Diabetes Care. 2013; 36:1020–5. https://doi.org/10.2337/dc12-1507 23275351

49. Shenoy C, Boura J, Orshaw P, Harjai KJ. Drug-eluting stents in patients with chronic kidney disease: a prospective registry study. PLoS One. 2010; 5:e15070. https://doi.org/10.1371/journal.pone.0015070 21124771

50. Zhang RY, Ni JW, Zhang JS, Hu J, Yang ZK, Zhang Q, et al. Long term clinical outcomes in patients with moderate renal insufficiency undergoing stent based percutaneous coronary intervention. Chin Med J (Engl). 2006; 119:1176–81. https://doi.org/10.1097/00029330-200607020-00007 16863609

51. Appleby CE, Ivanov J, Lavi S, Mackie K, Horlick EM, Ing D, et al. The adverse long-term impact of renal impairment in patients undergoing percutaneous coronary intervention in the drug-eluting stent era. Circ Cardiovasc Interv. 2009; 2:309–16. https://doi.org/10.1161/circinterventions.108.828954 20031733

52. Chen DY, Mao CT, Tsai ML, Hsieh MJ, Lin YS, Cherng WJ, et al. Clinical Outcomes of Drug-Eluting Stents vs. Bare-Metal Stents in Acute Myocardial Infarction Patients Under Dialysis—A Nationwide Cohort Study. Circ J. 2016; 80:363–70. https://doi.org/10.1253/circj.cj-15-0778 26581755

53. Iijima R, Araki T, Nagashima Y, Yamazaki K, Utsunomiya M, Hori M, et al. Incidence and predictors of the late catch-up phenomenon after drug-eluting stent implantation. Int J Cardiol. 2013; 168:2588–92. https://doi.org/10.1016/j.ijcard.2013.03.046 23578895

54. Tu JV, Bowen J, Chiu M, Ko DT, Austin PC, He Y, et al. Effectiveness and safety of drug-eluting stents in Ontario. N Engl J Med. 2007; 357:1393–402. https://doi.org/10.1056/nejmoa071076 17914040


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