Subscribe to RSS
DOI: 10.1055/s-0032-1302436
Two-Year Follow-up of Sirolimus-Eluting Stents versus Paclitaxel-Eluting Stents in Acute Myocardial Infarction
Publication History
Publication Date:
17 February 2012 (online)
![](https://www.thieme-connect.de/media/ija/201201/lookinside/thumbnails/10.1055-s-0032-1302436-1.jpg)
Abstract
It has been shown that drug-eluting stents (DESs) significantly reduce restenosis rate when compared with bare-metal stents in a broad range of patients with coronary artery disease. However, current data are limited about the efficacy of different DESs in treatment of ST segment elevation myocardial infarction (STEMI). The aim of this study was to compare the effectiveness and safety of sirolimus-eluting stents (SESs) with paclitaxel-eluting stents (PESs) in primary percutaneous coronary intervention. We retrospectively examined 127 STEMI patients who underwent primary percutaneous coronary intervention. PES group consisted of 79 patients and SES group consisted of 48 patients. Patients were analyzed for major adverse cardiac events (MACE) and stent thrombosis (ST). The mean follow-up period was 2 years. The mean age was 53 ± 11 years in the SES group and 59 ± 11 years in the PES group (p = 0.03). Baseline and procedural characteristics were similar in the two groups except stent lengths, which was longer in the SES group. Two-year MACE rates were 8.3% in the SES group and 16.4% in the PES group (p = 0.28). Rates for ST for SES and PES groups were as follows: early ST was 2.08 versus 2.53%; late ST was 2.08 versus 2.53%; and very late ST was 2.08 versus 2.53% (p > 0.05). There were no statistically significant differences in MACE and ST rates between the SES and PES groups in the 2-year follow-up period. High ST rates detected in our study need to be clarified with future prospective and randomized clinical trials.
-
References
- 1 Grines CL, Cox DA, Stone GW , et al; Stent Primary Angioplasty in Myocardial Infarction Study Group. Coronary angioplasty with or without stent implantation for acute myocardial infarction. N Engl J Med 1999; 341 (26) 1949-1956
- 2 Stone GW, Grines CL, Cox DA , et al; Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) Investigators. Comparison of angioplasty with stenting, with or without abciximab, in acute myocardial infarction. N Engl J Med 2002; 346 (13) 957-966
- 3 Morice MC, Serruys PW, Sousa JE , et al; RAVEL Study Group. Randomized Study with the Sirolimus-Coated Bx Velocity Balloon-Expandable Stent in the Treatment of Patients with de Novo Native Coronary Artery Lesions. A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. N Engl J Med 2002; 346 (23) 1773-1780
- 4 Moses JW, Leon MB, Popma JJ , et al; SIRIUS Investigators. Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med 2003; 349 (14) 1315-1323
- 5 Stone GW, Ellis SG, Cox DA , et al; TAXUS-IV Investigators. A polymer-based, paclitaxel-eluting stent in patients with coronary artery disease. N Engl J Med 2004; 350 (3) 221-231
- 6 Laarman GJ, Suttorp MJ, Dirksen MT , et al. Paclitaxel-eluting versus uncoated stents in primary percutaneous coronary intervention. N Engl J Med 2006; 355 (11) 1105-1113
- 7 Spaulding C, Henry P, Teiger E , et al; TYPHOON Investigators. Sirolimus-eluting versus uncoated stents in acute myocardial infarction. N Engl J Med 2006; 355 (11) 1093-1104
- 8 Spaulding C, Daemen J, Boersma E, Cutlip DE, Serruys PW. A pooled analysis of data comparing sirolimus-eluting stents with bare-metal stents. N Engl J Med 2007; 356 (10) 989-997
- 9 Kastrati A, Dibra A, Spaulding C , et al. Meta-analysis of randomized trials on drug-eluting stents vs. bare-metal stents in patients with acute myocardial infarction. Eur Heart J 2007; 28 (22) 2706-2713
- 10 De Luca G, Valgimigli M, Spaulding C , et al. Short and long-term benefits of sirolimus-eluting stent in ST-segment elevation myocardial infarction: a meta-analysis of randomized trials. J Thromb Thrombolysis 2009; 28 (2) 200-210
- 11 Windecker S, Remondino A, Eberli FR , et al. Sirolimus-eluting and paclitaxel-eluting stents for coronary revascularization. N Engl J Med 2005; 353 (7) 653-662
- 12 Galløe AM, Thuesen L, Kelbaek H , et al; SORT OUT II Investigators. Comparison of paclitaxel- and sirolimus-eluting stents in everyday clinical practice: the SORT OUT II randomized trial. JAMA 2008; 299 (4) 409-416
- 13 Lee JH, Kim HS, Lee SW , et al. Prospective randomized comparison of sirolimus- versus paclitaxel-eluting stents for the treatment of acute ST-elevation myocardial infarction: pROSIT trial. Catheter Cardiovasc Interv 2008; 72 (1) 25-32
- 14 Daemen J, Tanimoto S, García-García HM , et al. Comparison of three-year clinical outcome of sirolimus- and paclitaxel-eluting stents versus bare metal stents in patients with ST-segment elevation myocardial infarction (from the RESEARCH and T-SEARCH Registries). Am J Cardiol 2007; 99 (8) 1027-1032
- 15 Lee CW, Park DW, Lee SH , et al; ZEST-AMI Investigators. Comparison of the efficacy and safety of zotarilimus-, sirolimus-, and paclitaxel-eluting stents in patients with ST elevation myocardial infarction. Am J Cardiol 2009; 104: 1370-1376
- 16 Mauri L, Hsieh WH, Massaro JM, Ho KKL, D'Agostino R, Cutlip DE. Stent thrombosis in randomized clinical trials of drug-eluting stents. N Engl J Med 2007; 356 (10) 1020-1029
- 17 Stone GW, Lansky AJ, Pocock SJ , et al; HORIZONS-AMI Trial Investigators. Paclitaxel-eluting stents versus bare-metal stents in acute myocardial infarction. N Engl J Med 2009; 360 (19) 1946-1959
- 18 Romano M, Buffoli F, Tomasi L, Corrado L, Ferrari MR, Zanini R. Safety and effectiveness of drug eluting stent in patients with ST elevation myocardial infarction undergoing primary angioplasty. Catheter Cardiovasc Interv 2008; 71 (6) 759-763
- 19 Buonamici P, Marcucci R, Migliorini A , et al. Impact of platelet reactivity after clopidogrel administration on drug-eluting stent thrombosis. J Am Coll Cardiol 2007; 49 (24) 2312-2317