Risk of Heart Failure in Patients with ST-Elevation Myocardial Infarction Receiving Drug-Eluting Stent Implantation and Undefined Duration of Antiplatelets

It remains unknown as to whether the use of new-generation drug-eluting stent (NG-DES) in patients with ST-elevation myocardial infarction (STEMI) who receive an undefined duration of dual antiplatelet therapy (DAPT) reduces the risk of hospitalization for heart failure (HHF). In this population-bas...

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Bibliographic Details
Published in:Journal of personalized medicine 2022-02, Vol.12 (3), p.369
Main Authors: Chien, Li-Nien, Chen, Chun-Chao, Chang, Ya-Hui, Yu, Fa-Chang, Tsai, Chen-Ting, Liu, Hung-Yi, Yeh, Hung-I, Lin, Chao-Feng
Format: Article
Language:English
Subjects:
Age
Cardiovascular disease
Congestive heart failure
Coronary vessels
Drug delivery
Heart attacks
Heart failure
Implants
Myocardial infarction
Nonsteroidal anti-inflammatory drugs
Patients
Population studies
Precision medicine
Prescription drugs
Stents
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Summary:It remains unknown as to whether the use of new-generation drug-eluting stent (NG-DES) in patients with ST-elevation myocardial infarction (STEMI) who receive an undefined duration of dual antiplatelet therapy (DAPT) reduces the risk of hospitalization for heart failure (HHF). In this population-based retrospective cohort study, we applied propensity score matching to select 6831 pairs of patients with STEMI who had similar baseline characteristics and received either NG-DES or bare-metal stent (BMS) implantation between 1 January 2007 and 31 December 2016. The risk of stent-associated HHF was evaluated, wherein death was considered a competing risk. Rates of cumulative incidence competing risk for HHF at the 1, 2, 3, 4, and 5 year follow-up were lower in the NG-DES group (3.79%, 5.21%, 6.15%, 7.01%, and 8.29%, respectively) than in the BMS group (4.51%, 6.21%, 7.32%, 8.33%, and 9.83%, respectively). NG-DES implantation was associated with a lower risk of HHF than BMS implantation after 5 years, with an adjusted subdistribution hazard ratio of 0.82 (95% confidence interval 0.72−0.92, p = 0.001). These results accord with those of patients who received DAPT for >6 months. Our findings highlight that NG-DESs may reduce HHF risk in patients with STEMI receiving an undefined duration of DAPT.
ISSN:2075-4426
2075-4426
DOI:10.3390/jpm12030369