1. Comparison of rapamycin- and paclitaxel-eluting stents in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction.
- Author
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Juwana YB, Suryapranata H, Ottervanger JP, De Luca G, van't Hof AW, Dambrink JH, de Boer MJ, Gosselink AT, and Hoorntje JC
- Subjects
- Coronary Angiography, Female, Health Status Indicators, Humans, Male, Middle Aged, Myocardial Infarction mortality, Myocardial Infarction physiopathology, Myocardial Infarction therapy, Prospective Studies, Survival Analysis, Angioplasty, Balloon, Coronary, Antineoplastic Agents, Phytogenic therapeutic use, Immunosuppressive Agents therapeutic use, Myocardial Infarction drug therapy, Paclitaxel therapeutic use, Sirolimus therapeutic use
- Abstract
Compared with bare metal stents, sirolimus- and paclitaxel-eluting stents (SESs and PESs, respectively) have been shown to improve angiographic and clinical outcomes after percutaneous coronary intervention (PCI) in elective patients and those with ST-elevation myocardial infarction (STEMI). The aim of the present study was to compare SESs with PESs in patients with STEMI undergoing primary PCI. Patients with STEMI were randomized 1:1 to receive SESs (n = 196) or PESs (n = 201). The primary end point was late lumen loss at 9-month follow-up by quantitative coronary angiography. Secondary end points were major adverse cardiac clinical events (death, reinfarction, target vessel revascularization) at 1 month and 9 and 12 months. Three hundred ninety-seven patients with STEMI were randomized. The 2 groups had comparable baseline clinical and angiographic characteristics. Mortality was low, 1.5% after 30 days, 2.3% after 9 months, and 3.1% after 1 year. There was no difference in any clinical outcome at any follow-up period between the 2 treatment groups. Follow-up angiography was completed in 272 of 397 patients (69%). Mean +/- SD in-stent late loss was 0.01 +/- 0.42 mm in the SES group versus 0.21 +/- 0.50 mm in the PES group (difference -0.20 mm, p = 0.001). In conclusion, in patients with STEMI, primary PCI with SESs results in less late loss compared with PESs. However, these benefits did not translate into a significant decrease in major adverse cardiac events at 1-year follow-up.
- Published
- 2009
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