Impact of myocardial infarction status on long-term outcomes after PCI with the ultimaster biodegradable-polymer sirolimus-eluting stent
8 affiliations
- 1Department of Cardiology, St. Vincent’s Hospital, The Catholic University of Korea
- 2Catholic Research Institute for Intractable Cardiovascular Disease (CRID), College of Medicine, The Catholic University of Korea
- 3Department of Cardiology, Soonchunhyang University Cheonan Hospital
- 4Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine
- 5Division of Cardiology, Department of Internal Medicine, Dankook University Hospital
- 6Department of Cardiology in Internal Medicine, Chungnam National University Hospital
- 7Department of Cardiology in Internal Medicine, Good Samsun Hospital
- 8Department of Cardiology, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea
Abstract
Background: Patients presenting with acute myocardial infarction (MI) represent a high-risk population after percutaneous coronary intervention (PCI), characterized by plaque instability, residual thrombus burden, and heightened ischemic and bleeding risk. However, the time-dependent risk profile and long-term durability of stent-related outcomes according to MI status have not been characterized for the Ultimaster TM biodegradable-polymer sirolimus-eluting stent (BP-SES). We evaluated clinical outcomes according to MI status using a 1-month landmark approach.
Methods: In this prospective, multicenter Korean registry, 932 patients who underwent PCI with the Ultimaster TM or Ultimaster TM Tansei TM BP-SES were stratified into MI ( n = 346) and non-MI ( n = 586) groups. The primary endpoint was net adverse clinical events (NACE), a composite of cardiac death, MI, cerebrovascular accident, bleeding, and definite or probable stent thrombosis, assessed at 1 month, at 1 year, and from 1 month to 3 years using a 1-month landmark analysis.
Results: At 1 month, NACE was significantly higher in the MI group [12.1% vs. 7.0%; hazard ratio [HR] 1.66, 95% confidence interval [CI] 1.01–2.72; p = 0.045], driven primarily by numerical excesses in cardiac death and bleeding. At 1 year, the cumulative incidence of NACE was numerically higher in the MI group (20.5% vs. 14.9%), a relative difference of approximately 40% without statistical significance, and 1-year target lesion failure was low and comparable (7.2% vs. 5.3%; p = 0.482). In the 1-month landmark analysis evaluating events from 1 month to 3 years, no significant differences were observed for any endpoint, including NACE (12.4% vs. 13.3%; HR 0.84, 95% CI 0.55–1.29; p = 0.425).
Conclusion: The early excess of clinical events in MI patients undergoing PCI with the Ultimaster TM BP-SES did not extend beyond the first month, and no significant differences in outcomes through 3 years were detected compared with non-MI patients. These findings suggest that, in the era of contemporary BP-SES and contemporary secondary prevention, MI status itself does not appear to be a major determinant of long-term outcomes after PCI, and are reassuring for the use of BP-SES across the spectrum of clinical presentations.
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BibTeX
@article{yoo2026impact,
title = {{Impact of myocardial infarction status on long-term outcomes after PCI with the ultimaster biodegradable-polymer sirolimus-eluting stent}},
author = {Ki-Dong Yoo and Hun-Joo Lee and Sang-Suk Choi and Gyung-Min Park and Jin Jung and Seong-Hoon Lim and Sung-Ho Her and Jae-Hwan Lee and Seung Jin Lee and Jang-Whan Bae and Kyusup Lee},
journal = {Frontiers in Cardiovascular Medicine},
year = {2026},
month = oct,
doi = {10.3389/fcvm.2026.1903710},
url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1903710/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Impact of myocardial infarction status on long-term outcomes after PCI with the ultimaster biodegradable-polymer sirolimus-eluting stent
AU - Ki-Dong Yoo
AU - Hun-Joo Lee
AU - Sang-Suk Choi
AU - Gyung-Min Park
AU - Jin Jung
AU - Seong-Hoon Lim
AU - Sung-Ho Her
AU - Jae-Hwan Lee
AU - Seung Jin Lee
AU - Jang-Whan Bae
AU - Kyusup Lee
PY - 2026
DA - 2026/10/30
JO - Frontiers in Cardiovascular Medicine
DO - 10.3389/fcvm.2026.1903710
UR - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1903710/full
AB - Background: Patients presenting with acute myocardial infarction (MI) represent a high-risk population after percutaneous coronary intervention (PCI), characterized by plaque instability, residual thrombus burden, and heightened ischemic and bleeding risk. However, the time-dependent risk profile and long-term durability of stent-related outcomes according to MI status have not been characterized for the Ultimaster TM biodegradable-polymer sirolimus-eluting stent (BP-SES). We evaluated clinical outcomes according to MI status using a 1-month landmark approach. Methods: In this prospective, multicenter Korean registry, 932 patients who underwent PCI with the Ultimaster TM or Ultimaster TM Tansei TM BP-SES were stratified into MI ( n = 346) and non-MI ( n = 586) groups. The primary endpoint was net adverse clinical events (NACE), a composite of cardiac death, MI, cerebrovascular accident, bleeding, and definite or probable stent thrombosis, assessed at 1 month, at 1 year, and from 1 month to 3 years using a 1-month landmark analysis. Results: At 1 month, NACE was significantly higher in the MI group [12.1% vs. 7.0%; hazard ratio [HR] 1.66, 95% confidence interval [CI] 1.01–2.72; p = 0.045], driven primarily by numerical excesses in cardiac death and bleeding. At 1 year, the cumulative incidence of NACE was numerically higher in the MI group (20.5% vs. 14.9%), a relative difference of approximately 40% without statistical significance, and 1-year target lesion failure was low and comparable (7.2% vs. 5.3%; p = 0.482). In the 1-month landmark analysis evaluating events from 1 month to 3 years, no significant differences were observed for any endpoint, including NACE (12.4% vs. 13.3%; HR 0.84, 95% CI 0.55–1.29; p = 0.425). Conclusion: The early excess of clinical events in MI patients undergoing PCI with the Ultimaster TM BP-SES did not extend beyond the first month, and no significant differences in outcomes through 3 years were detected compared with non-MI patients. These findings suggest that, in the era of contemporary BP-SES and contemporary secondary prevention, MI status itself does not appear to be a major determinant of long-term outcomes after PCI, and are reassuring for the use of BP-SES across the spectrum of clinical presentations.
SN - 2297-055X
ER -