Background
We evaluated the 2‐year clinical outcomes of ST‐elevation myocardial infarction (STEMI) and non‐STEMI (NSTEMI) in patients with chronic kidney disease (CKD) who received newer‐generation drug‐eluting stents (DES).
Methods
Overall, 18,875 acute myocardial infarction patients were divided into two groups: CKD (STEMI, n = 1707; NSTEMI, n = 1648) and non‐CKD (STEMI, n = 8660; NSTEMI, n = 6860). The occurrence of major adverse cardiac events (MACE), defined as all‐cause death, recurrent myocardial infarction (re‐MI), any repeat coronary revascularization, and definite or probable stent thrombosis (ST), was evaluated.
Results
After multivariable‐adjusted analysis, in the CKD group, the MACE (adjusted hazard ratio [aHR]: 1.365, p = 0.004), all‐cause death (aHR: 1.503, p = 0.004), noncardiac death (non‐CD; aHR: 1.960, p = 0.004), and all‐cause death or MI rates (aHR: 1.458, p = 0.002) were significantly higher in the NSTEMI group than in the STEMI group. In the non‐CKD group, the non‐CD rate (aHR: 1.78, p = 0.006) was also higher in the NSTEMI group. The CD, re‐MI, any repeat revascularization, and ST rates were similar between groups. In the CKD group, from 6 months to 2 years after the index procedure, all‐cause death, non‐CD, and all‐cause death or MI rates were significantly higher in the NSTEMI group than in the STEMI group. These results may be related to the higher non‐CD rate in the NSTEMI group.
Conclusions
In the era of contemporary newer‐generation DES, NSTEMI showed a relatively higher non‐CD rate than STEMI in both CKD and non‐CKD groups.