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A Comparison of ST Elevation versus Non-ST Elevation Myocardial Infarction Outcomes: A Substudy of the EVER-ZOTA Trial (a Randomized Comparison Study of Everolimus-Eluting versus Zotarolimus-Eluting Stent in acute myocardial infarction)
강원대학교 병원¹ , 강릉아산병원² , 원주기독병원³ , 춘천성심병원⁴
이봉기¹ , 조병렬¹ , 류동열¹ , 윤정한² , 이승환² , 안성균² , 윤영진² , 정상식³ , 유상용³ , 윤덕형⁴, 최현희⁴
BACKGROUND: The aim of this study is to compare prognosis between ST elevation myocardial infarction(STEMI) and non-ST elevation myocardial infarction(NSTEMI) treated by percutaneous coronary intervention(PCI) using Everolimus-eluting stent(EES) or Zotarolimus-eluting stent(ZES). METHODS: Patients enrolled in the EVER-ZOTA trial (a randomized comparison of a EES versus ZES for coronary lesions in acute myocardial infarction) were stratified into STEMI and NSTEMI and compared for prognosis and other variables. RESULTS: Total enrolled subjects were 497 patients(STEMI=62.5% vs NSTEMI=37.5%) with 630 lesions (EES=49% vs ZES=51%). The proportions of male gender(75.2% vs 67%, p<0.01), hypercholesterolemia(21.8% vs 13.0%, p<0.02) were higher and age(63.8±12.7 vs 66.5±11.5, p<0.01), CRP level(3.8±11.6 vs 9.2±21.4mg/dl, p<0.01) were lower among STEMI patients than in the NSTEMI group. Used stents were bigger in STEMI than NSTEMI patients(3.19±0.38 vs 3.03±0.38 mm, p<0.001). Twelve month mortality was higher (6.5% vs 1.8%, p = 0.01) in STEMI group. Total major adverse cardiovascular events(MACE; 7.8% vs 4.3%, p=0.18), target vessel revascularization (2.0% vs 3.8%, p=0.16), binary in-stent restenosis(2.3% vs 4.3%, p=0.28) and stent thrombosis (2.6% vs 1.1%, p=0.41) were occurred not differently between STEMI and NSTEMI groups. MACE showed no significant difference between EES and ZES in log lank test stratified by STEMI and NSTEMI. CONCLUSION: Patients with NSTEMI were older and showed a higher CRP than STEMI patients. NSTEMI patients had lower 1 year mortality, but showed no significant difference in MACE rate. There was no significant difference in MACE between EES and ZES stratified by STEMI and NSTEMI.


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