Everolimus- and sirolimus-eluting stents in patients with and without ST-segment elevation myocardial infarction |
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Authors: | M A Velders A J van Boven J Brouwer P C Smits A W J van ’t Hof C J de Vries M Queré S H Hofma |
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Institution: | 1. Department of Cardiology, Medical Center Leeuwarden, PO Box 888, 8901 BR, Leeuwarden, the Netherlands 2. Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands 3. Department of Cardiology, Isala Clinics, Zwolle, the Netherlands
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Abstract: | Aims Everolimus-eluting stents (EES) were superior to sirolimus-eluting stents (SES) in a dedicated myocardial infarction trial, a finding that was not observed in trials with low percentages of ST-elevation myocardial infarction (STEMI). Therefore, this study sought to investigate the influence of clinical presentation on outcome after EES and SES implantation. Methods A pooled population of 1602 randomised patients was formed from XAMI (acute MI trial) and APPENDIX-AMI (all-comer trial). Primary outcome was cardiac mortality, MI and target vessel revascularisation at 2 years. Secondary endpoints included definite/probable stent thrombosis (ST). Adjustment was done using Cox regression. Results In total, 902 EES and 700 SES patients were included, of which 44 % STEMI patients (EES 455; SES 257) and 56 % without STEMI (EES 447; SES 443). In the pooled population, EES and SES showed similar outcomes during follow-up. Moreover, no differences in the endpoints were observed after stratification according to presentation. Although a trend toward reduced early definite/probable ST was observed in EES compared with SES in STEMI patients, long-term ST rates were low and comparable. Conclusions EES and SES showed a similar outcome during 2-year follow-up, regardless of clinical presentation. Long-term safety was excellent for both devices, despite wide inclusion criteria and a large sub-population of STEMI patients. |
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Keywords: | Drug-eluting stents Percutaneous coronary intervention Coronary artery disease |
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