Use of drug-eluting stents in acute myocardial infarction with persistent ST-segment elevation: results of the ALKK PCI-registry
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  • 作者:Tobias H?rle (1)
    Uwe Zeymer (2) (3)
    Arne Kristian Schwarz (1)
    Claus Lüers (1)
    Matthias Hochadel (3)
    Harald Darius (4)
    Wolfgang Kasper (5)
    Karl Eugen Hauptmann (6)
    Dietrich Andresen (7)
    Albrecht Els?sser (1)
  • 关键词:Drug ; eluting stent ; Myocardial infarction ; STEMI ; Germany
  • 刊名:Clinical Research in Cardiology
  • 出版年:2014
  • 出版时间:May 2014
  • 年:2014
  • 卷:103
  • 期:5
  • 页码:373-380
  • 全文大小:318 KB
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  • 作者单位:Tobias H?rle (1)
    Uwe Zeymer (2) (3)
    Arne Kristian Schwarz (1)
    Claus Lüers (1)
    Matthias Hochadel (3)
    Harald Darius (4)
    Wolfgang Kasper (5)
    Karl Eugen Hauptmann (6)
    Dietrich Andresen (7)
    Albrecht Els?sser (1)

    1. Klinikum Oldenburg, Klinik für Kardiologie, Rahel-Straus-Str. 10, 26133, Oldenburg, Germany
    2. Klinikum Ludwigshafen, Medizinische Klinik B, Ludwigshafen, Germany
    3. Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany
    4. Vivantes Klinikum Neuk?lln, Klinik für Kardiologie, Angiologie und Intensivmedizin, Berlin, Germany
    5. St. Josefs-Hospital, Medizinische Klinik I, Wiesbaden, Germany
    6. Krankenhaus der Barmherzigen Brüder, Abteilung für Kardiologie, Trier, Germany
    7. Vivantes Klinikum Am Urban/Im Friedrichshain, Abteilung für Kardiologie, Berlin, Germany
  • ISSN:1861-0692
文摘
Background Drug-eluting stents (DES) reduce the rate of in-stent restenosis (ISR) and target vessel revascularization significantly when compared with bare metal stents (BMS). Their beneficial effects have been demonstrated in patients with acute myocardial infarction also, but the use of DES in the latter population seems to be still limited in clinical practice. Methods and results From January 2006 to December 2011, 25,424 patients with ST-elevation myocardial infarction were enrolled in the German ALKK PCI-registry. In 5,467 patients (21.5?%), a DES was implanted in the culprit segment, in 16,911 patients (66.5?%) a BMS, and 2,959 patients (11.6?%) received neither DES nor BMS. The rates of DES for typical subgroups were 31.7?% in patients with diabetes, 36.6?% in unprotected left main stenosis, 32.4?% in ostial lesions, 32.0?% for a stent length >15?mm, 26.2?% for a stent diameter ??mm, and 58.5?% for ISR. There was a wide range in the use of DES between the different ALKK hospitals with a minimum of 2.3?% and a maximum of 58.3?% for the total study period (median 22.0?%, quartiles 14.6 and 37.5?%). Conclusions Despite convincing data for the use of DES in patients with STEMI, there is still an underuse of DES in this clinical setting in Germany. This is particularly worrying for the subgroups of patients and lesions with a high risk of restenosis. Further efforts are needed to reduce the skepticism about DES and to improve guideline adherent treatment.

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