10-Year Follow-Up of Patients With Everolimus-Eluting Versus Bare-Metal Stents After ST-Segment Elevation Myocardial Infarction
| Autor: | Marcelo Jimenez, Antonio Serra, Victor Alfonso Jimenez-Diaz, Josep Gomez-Lara, Xacobe Flores, Matteo Tebaldi, Victor Arévalos, Alfonso Ielasi, Loreto Oyarzabal, Mattie J. Lenzen, Nieves Gonzalo, Roberto Diletti, Manel Sabaté, Simone Biscaglia, Andrés Iñiguez, Gianluca Campo, Patrick W. Serruys, Salvatore Brugaletta, Jaume Maristany, Rafael Romaguera, Maurizio Tespili, Joan Antoni Gómez-Hospital, Luis Ortega-Paz, Antonio De Miguel-Castro, Juan José Rodríguez-Arias, Vicente Mainar, Pilar Jiménez-Quevedo, Luis Nombela-Franco, Soheil Al-Shaibani, Antonio Silvestro, Pascual Bordes |
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| Přispěvatelé: | Cardiology |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment 030204 cardiovascular system & hematology Revascularization Prosthesis Design everolimus randomized controlled trial ST-segment elevation myocardial infarction stent stent thrombosis NO 03 medical and health sciences 0302 clinical medicine Pregnancy Internal medicine medicine Clinical endpoint Myocardial Revascularization ST segment Humans Single-Blind Method 030212 general & internal medicine Myocardial infarction Prospective Studies Everolimus business.industry Dual Anti-Platelet Therapy Hazard ratio Stent Percutaneous coronary intervention Drug-Eluting Stents medicine.disease Metals Cardiology ST Elevation Myocardial Infarction Female Stents Cardiology and Cardiovascular Medicine business Immunosuppressive Agents medicine.drug Follow-Up Studies |
| Zdroj: | Journal of the American College of Cardiology, 77(9), 1165-1178. Elsevier Inc. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante |
| ISSN: | 0735-1097 |
| Popis: | BACKGROUND Outcomes data for a durable-polymer everolimus-eluting stent (EES) at extended long-term follow-up in patients with ST-segment elevation myocardial infarction (STEMI) are unknown. OBJECTIVES The aim of this study was to assess the 10-year outcomes of patients enrolled in the EXAMINATION (A Clinical Evaluation of Everolimus Eluting Coronary Stents in the Treatment of Patients With ST-Segment Elevation Myocardial Infarction) trial. METHODS The EXAMINATION-EXTEND (10-Years Follow-Up of the EXAMINATION Trial) study is an investigator-driven 10-year follow-up of the EXAMINATION trial, which randomly assigned 1,498 patients with STEMI in a 1:1 ratio to receive either EES (n = 751) or bare-metal stents (n = 747). The primary endpoint was a patient-oriented composite endpoint of all-cause death, any myocardial infarction, or any revascularization. Secondary endpoints included a device-oriented composite endpoint of cardiac death, target vessel myocardial infarction, or target lesion revascularization; the individual components of the combined endpoints; and stent thrombosis. RESULTS Complete 10-year clinical follow-up was obtained in 94.5% of the EES group and 95.9% of the bare-metal stent group. Rates of the patient-oriented composite endpoint and device-oriented composite endpoint were significantly reduced in the EES group (32.4% vs. 38.0% [hazard ratio: 0.81; 95% confidence interval: 0.68 to 0.96; p = 0.013] and 13.6% vs. 18.4% [hazard ratio: 0.72; 95% confidence interval: 0.55 to 0.93; p = 0.012], respectively), driven mainly by target lesion revascularization (5.7% vs. 8.8%; p = 0.018). The rate of definite stent thrombosis was similar in both groups (2.2% vs. 2.5%; p = 0.590). No differences were found between the groups in terms of target lesion revascularization (1.4% vs. 1.3%; p = 0.963) and definite or probable stent thrombosis (0.6% vs. 0.4%; p = 0.703) between 5 and 10 years. CONCLUSIONS At 10-year follow-up, EES demonstrated confirmed superiority in combined patient- and device-oriented composite endpoints compared with bare-metal stents in patients with STEMI requiring primary percutaneous coronary intervention. Between 5- and 10-year follow-up, a low incidence of adverse cardiovascular events related to device failure was found in both groups. (10-Years Follow-Up of the EXAMINATION Trial; NCT04462315) (c) 2021 by the American College of Cardiology Foundation. |
| Databáze: | OpenAIRE |
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