ADAPT-DES: Non-periprocedural MI within 2 years after DES implantation infrequent

Two-year data from the ADAPT-DES study demonstrate that the occurrence of non-periprocedural MI after successful drug-eluting stent implantation was infrequent, but associated with subsequent death.

ADAPT-DES is a prospective, multicenter, registry study. Overall, 8,582 patients who underwent successful DES implantation at 11 sites in Germany and the United States were enrolled. Researchers excluded 128 patients with periprocedural MI to study the frequency, pathogenesis and long-term outcomes of non-periprocedural MI (n = 8,454).

At 2-year follow-up, 3.3% of patients had experienced MI (median time of 318 days). Approximately 30% of MIs were classified as spontaneous, 24.3% secondary or intermediate, 24% related to stent thrombosis and 22.1% related to in-stent restenosis.

The following were identified as multivariable predictors of MI: ACS, diabetes, current smoking status, multivessel disease, in-stent restenosis lesion treatment, low baseline hemoglobin, decreased creatinine clearance, higher on-treatment platelet P2Y12 receptor reactivity, premature thienopyridine cessation and no statin therapy at discharge.

Two-year mortality was significantly higher among patients who experienced MI during follow-up compared with those without MI (17.3% vs. 3.4%; P < .001).

Multivariable analysis revealed an adjusted HR of 2.17 (95% CI, 1.06-4.45) for subsequent death during follow-up among patients who experienced non-periprocedural MI compared with patients without non-periprocedural MI.

“Among patients undergoing successful PCI with DES implantation in the present multicenter study, although the frequency of non-periprocedural MI occurring during 2-year follow-up was relatively low, such events were significantly associated with subsequent mortality,” the researchers wrote. “The different etiologies of non-periprocedural MI suggests that a multipronged approach to their prevention is necessary further improve PCI outcomes.” – by Jennifer Byrne
 

Disclosure: Please see the full study for a list of the authors’ relevant financial disclosures.

Source:  www.healio.com