Abstract | OBJECTIVES: The aim of the current study was to compare everolimus-eluting stents (EES) with sirolimus-eluting stents (SES) in patients undergoing primary angioplasty. BACKGROUND: METHODS: Consecutive STEMI patients admitted within 12 h of symptom onset and undergoing primary angioplasty and stent implantation at a tertiary center with 24-h primary percutaneous coronary intervention capability were randomly assigned to SES or EES. The primary endpoint was a major adverse cardiac event at 3-year follow-up. The secondary endpoints were death, reinfarction, definite or probable stent thrombosis, and target vessel revascularization at 3-year follow-up. No patient was lost to follow-up. RESULTS: From April 2007 to May 2009, 500 patients with STEMI were randomized to EES (n = 250) or SES (n = 250). No difference was observed in terms of baseline demographic and clinical characteristics between the groups. No difference was observed between the groups in terms of number of implanted stents per patient or total stent length. However, a larger reference diameter was observed with SES (3.35 ± 0.51 mm vs. 3.25 ± 0.51 mm, p = 0.001), whereas patients randomized to EES more often received glycoprotein IIb/IIIa inhibitors (54.4% vs. 42.4%, p = 0.006). Follow-up data were available in all patients (1,095 ± 159 days). No significant difference was observed between EES and SES in major adverse cardiac events (16% vs. 20.8%, adjusted hazard ratio [HR]: 0.75 [95% confidence interval (CI): 0.5 to 1.13], p = 0.17), cardiac death (4.4% vs. 5.6%, adjusted HR: 0.77 [95% CI: 0.35 to 1.71], p = 0.53), recurrent MI (6.4% vs. 10%, adjusted HR: 0.62 [95% CI: 0.33 to 1.16], p = 0.13), and target vessel revascularization (4.8% vs. 4.8%, adjusted HR: 1.00 [95% CI: 0.45 to 2.32], p = 0.99). However, EES was associated with a significant reduction in stent thrombosis (1.6% vs. 5.2%, adjusted HR: 0.3 [95% CI: 0.1 to 0.92], p = 0.035). CONCLUSIONS:
|
Authors | Emilio Di Lorenzo, Rosario Sauro, Attilio Varricchio, Michele Capasso, Tonino Lanzillo, Fiore Manganelli, Giannignazio Carbone, Francesca Lanni, Maria Rosaria Pagliuca, Giovanni Stanco, Giuseppe Rosato, Harry Suryapranata, Giuseppe De Luca |
Journal | JACC. Cardiovascular interventions
(JACC Cardiovasc Interv)
Vol. 7
Issue 8
Pg. 849-56
(Aug 2014)
ISSN: 1876-7605 [Electronic] United States |
PMID | 25147029
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
|
Copyright | Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Cardiovascular Agents
- Platelet Aggregation Inhibitors
- Everolimus
|
Topics |
- Aged
- Angioplasty, Balloon, Coronary
(adverse effects, instrumentation, mortality)
- Cardiovascular Agents
(administration & dosage)
- Coronary Thrombosis
(etiology, mortality)
- Drug-Eluting Stents
- Everolimus
(administration & dosage)
- Female
- Humans
- Italy
- Kaplan-Meier Estimate
- Male
- Middle Aged
- Myocardial Infarction
(diagnosis, mortality, therapy)
- Platelet Aggregation Inhibitors
(administration & dosage)
- Proportional Hazards Models
- Prospective Studies
- Prosthesis Design
- Recurrence
- Risk Factors
- Tertiary Care Centers
- Time Factors
- Treatment Outcome
|