Comparison of Late (3-Year) Registry Data Outcomes Using Bare Metal Versus Drug-Eluting Stents for Treating ST-Segment Elevation Acute Myocardial Infarctions
Clinical trial data have supported the safety and efficacy of drug-eluting stents (DES) in the treatment of patients with ST-segment elevation myocardial infarctions (STEMIs), but contemporary “real-world” registry data regarding the late safety profiles of DES are limited. This prospective registry...
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| Veröffentlicht in: | The American journal of cardiology 2012-06, Vol.109 (11), p.1563-1568 |
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| creator | Assali, Abid, MD Vaduganathan, Muthiah, MD, MPH Vaknin-Assa, Hanna, MD Lev, Eli I., MD Brosh, David, MD Teplitsky, Igal, MD Bental, Tamir, MD Battler, Alexander, MD Kornowski, Ran, MD |
| description | Clinical trial data have supported the safety and efficacy of drug-eluting stents (DES) in the treatment of patients with ST-segment elevation myocardial infarctions (STEMIs), but contemporary “real-world” registry data regarding the late safety profiles of DES are limited. This prospective registry-based study included 1,569 consecutive unselected patients with STEMIs who underwent emergency primary percutaneous coronary intervention from January 2001 to December 2009. Of the study cohort, 200 patients (12.7%) received DES, while 1,369 patients (87.3%) underwent bare-metal stent (BMS) placement. The primary end points of the study were all-cause mortality and target vessel revascularization at 1, 2, and 3 years. Survival status was assessed by municipal civil registries. Repeat revascularization procedures were prospectively collected in the hospital database. All-cause mortality was significantly lower in the DES group at 3 years (4.2% vs 13.5%, p = 0.007) compared to BMS-treated patients, but DES use was not an independent predictor of all-cause mortality (adjusted odds ratio 0.5, 95% confidence interval 0.2 to 1.2, p = 0.10). Target vessel revascularization was significantly lower in the DES group compared to the BMS group at 3 years (10.5% vs 21%, p = 0.001). DES use was an independent predictor of reduced target vessel revascularization (adjusted odds ratio 0.44, 95% confidence interval 0.25 to 0.77, p = 0.004). Late definite stent thrombosis occurring after 1 year occurred in 4 (2.5%) patients in the DES group compared to 6 (0.7%) in the BMS group (p = 0.05). DES use was an independent predictor of late stent thrombosis (adjusted odds ratio 8.6, 95% confidence interval 1.9 to 38, p = 0.004). In conclusion, this contemporary registry-based study of patients who underwent primary percutaneous coronary intervention for STEMI demonstrated improved revascularization rates without increased 3-year hazard of adverse clinical outcomes in DES-treated patients. |
| doi_str_mv | 10.1016/j.amjcard.2012.01.378 |
| format | Article |
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This prospective registry-based study included 1,569 consecutive unselected patients with STEMIs who underwent emergency primary percutaneous coronary intervention from January 2001 to December 2009. Of the study cohort, 200 patients (12.7%) received DES, while 1,369 patients (87.3%) underwent bare-metal stent (BMS) placement. The primary end points of the study were all-cause mortality and target vessel revascularization at 1, 2, and 3 years. Survival status was assessed by municipal civil registries. Repeat revascularization procedures were prospectively collected in the hospital database. All-cause mortality was significantly lower in the DES group at 3 years (4.2% vs 13.5%, p = 0.007) compared to BMS-treated patients, but DES use was not an independent predictor of all-cause mortality (adjusted odds ratio 0.5, 95% confidence interval 0.2 to 1.2, p = 0.10). Target vessel revascularization was significantly lower in the DES group compared to the BMS group at 3 years (10.5% vs 21%, p = 0.001). DES use was an independent predictor of reduced target vessel revascularization (adjusted odds ratio 0.44, 95% confidence interval 0.25 to 0.77, p = 0.004). Late definite stent thrombosis occurring after 1 year occurred in 4 (2.5%) patients in the DES group compared to 6 (0.7%) in the BMS group (p = 0.05). DES use was an independent predictor of late stent thrombosis (adjusted odds ratio 8.6, 95% confidence interval 1.9 to 38, p = 0.004). In conclusion, this contemporary registry-based study of patients who underwent primary percutaneous coronary intervention for STEMI demonstrated improved revascularization rates without increased 3-year hazard of adverse clinical outcomes in DES-treated patients.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2012.01.378</identifier><identifier>PMID: 22440117</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Angioplasty, Balloon, Coronary ; Biological and medical sciences ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; Coronary heart disease ; Coronary Stenosis - mortality ; Coronary Stenosis - therapy ; Coronary Thrombosis - epidemiology ; Diabetes Mellitus - epidemiology ; Drug-Eluting Stents ; Female ; Follow-Up Studies ; Heart ; Heart attacks ; Humans ; Male ; Medical sciences ; Middle Aged ; Mortality ; Multivariate Analysis ; Myocardial Infarction - mortality ; Myocardial Infarction - therapy ; Myocarditis. Cardiomyopathies ; Platelet Glycoprotein GPIIb-IIIa Complex - therapeutic use ; Propensity Score ; Prospective Studies ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Recurrence ; Registries ; Renal Insufficiency - epidemiology ; Retreatment ; Stents ; Thrombosis</subject><ispartof>The American journal of cardiology, 2012-06, Vol.109 (11), p.1563-1568</ispartof><rights>Elsevier Inc.</rights><rights>2012 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Sequoia S.A. Jun 1, 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c478t-bdbd86ea9dc67f1ce437f8894d0bf6dd94ddca8f38b9b18152435cb0300db2973</citedby><cites>FETCH-LOGICAL-c478t-bdbd86ea9dc67f1ce437f8894d0bf6dd94ddca8f38b9b18152435cb0300db2973</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.amjcard.2012.01.378$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,782,786,3552,27931,27932,46002</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25967898$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22440117$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Assali, Abid, MD</creatorcontrib><creatorcontrib>Vaduganathan, Muthiah, MD, MPH</creatorcontrib><creatorcontrib>Vaknin-Assa, Hanna, MD</creatorcontrib><creatorcontrib>Lev, Eli I., MD</creatorcontrib><creatorcontrib>Brosh, David, MD</creatorcontrib><creatorcontrib>Teplitsky, Igal, MD</creatorcontrib><creatorcontrib>Bental, Tamir, MD</creatorcontrib><creatorcontrib>Battler, Alexander, MD</creatorcontrib><creatorcontrib>Kornowski, Ran, MD</creatorcontrib><title>Comparison of Late (3-Year) Registry Data Outcomes Using Bare Metal Versus Drug-Eluting Stents for Treating ST-Segment Elevation Acute Myocardial Infarctions</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Clinical trial data have supported the safety and efficacy of drug-eluting stents (DES) in the treatment of patients with ST-segment elevation myocardial infarctions (STEMIs), but contemporary “real-world” registry data regarding the late safety profiles of DES are limited. This prospective registry-based study included 1,569 consecutive unselected patients with STEMIs who underwent emergency primary percutaneous coronary intervention from January 2001 to December 2009. Of the study cohort, 200 patients (12.7%) received DES, while 1,369 patients (87.3%) underwent bare-metal stent (BMS) placement. The primary end points of the study were all-cause mortality and target vessel revascularization at 1, 2, and 3 years. Survival status was assessed by municipal civil registries. Repeat revascularization procedures were prospectively collected in the hospital database. All-cause mortality was significantly lower in the DES group at 3 years (4.2% vs 13.5%, p = 0.007) compared to BMS-treated patients, but DES use was not an independent predictor of all-cause mortality (adjusted odds ratio 0.5, 95% confidence interval 0.2 to 1.2, p = 0.10). Target vessel revascularization was significantly lower in the DES group compared to the BMS group at 3 years (10.5% vs 21%, p = 0.001). DES use was an independent predictor of reduced target vessel revascularization (adjusted odds ratio 0.44, 95% confidence interval 0.25 to 0.77, p = 0.004). Late definite stent thrombosis occurring after 1 year occurred in 4 (2.5%) patients in the DES group compared to 6 (0.7%) in the BMS group (p = 0.05). DES use was an independent predictor of late stent thrombosis (adjusted odds ratio 8.6, 95% confidence interval 1.9 to 38, p = 0.004). In conclusion, this contemporary registry-based study of patients who underwent primary percutaneous coronary intervention for STEMI demonstrated improved revascularization rates without increased 3-year hazard of adverse clinical outcomes in DES-treated patients.</description><subject>Angioplasty, Balloon, Coronary</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Coronary heart disease</subject><subject>Coronary Stenosis - mortality</subject><subject>Coronary Stenosis - therapy</subject><subject>Coronary Thrombosis - epidemiology</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Drug-Eluting Stents</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Myocardial Infarction - mortality</subject><subject>Myocardial Infarction - therapy</subject><subject>Myocarditis. Cardiomyopathies</subject><subject>Platelet Glycoprotein GPIIb-IIIa Complex - therapeutic use</subject><subject>Propensity Score</subject><subject>Prospective Studies</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Recurrence</subject><subject>Registries</subject><subject>Renal Insufficiency - epidemiology</subject><subject>Retreatment</subject><subject>Stents</subject><subject>Thrombosis</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFktFu0zAUhiMEYmXwCCBLCGm7SLATJ7FvQKMrMKnTJNohcWU59knlksTFdib1YfauOLQwaTdc2T7nO_859u8keU1wRjCp3m8z2W-VdDrLMckzTLKiZk-SGWE1TwknxdNkhjHOU04oP0leeL-NR0LK6nlykueUxn09S-7ntt9JZ7wdkG3RUgZAZ0X6A6Q7R99gY3xwe3Qpg0Q3Y1C2B49uvRk26JN0gK4hyA59B-dHjy7duEkX3Rim9CrAEDxqrUNrB_IQW6cr2PQxgRYd3MVg7Hqhxtjzem-ny5iodjW00qkp518mz1rZeXh1XE-T28-L9fxrurz5cjW_WKaK1iykjW40q0Byraq6JQpoUbeMcapx01Zax41WkrUFa3hDGClzWpSqwQXGusl5XZwmZwfdnbO_RvBB9MYr6Do5gB29iC9e1BUlNYno20fo1o5uiNP9oSiN0ixS5YFSznrvoBU7Z3rp9hGauEpsxdE_MfknMBHRv1j35qg-Nj3of1V_DYvAuyMgvZJd6-SgjH_gSl7VjE9CHw8cxGe7M-CEVwYGBdo4UEFoa_47yodHCqozg4lNf8Ie_MOthY81YjV9tumvkRzjktO8-A3GGNDp</recordid><startdate>20120601</startdate><enddate>20120601</enddate><creator>Assali, Abid, MD</creator><creator>Vaduganathan, Muthiah, MD, MPH</creator><creator>Vaknin-Assa, Hanna, MD</creator><creator>Lev, Eli I., MD</creator><creator>Brosh, David, MD</creator><creator>Teplitsky, Igal, MD</creator><creator>Bental, Tamir, MD</creator><creator>Battler, Alexander, MD</creator><creator>Kornowski, Ran, MD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20120601</creationdate><title>Comparison of Late (3-Year) Registry Data Outcomes Using Bare Metal Versus Drug-Eluting Stents for Treating ST-Segment Elevation Acute Myocardial Infarctions</title><author>Assali, Abid, MD ; Vaduganathan, Muthiah, MD, MPH ; Vaknin-Assa, Hanna, MD ; Lev, Eli I., MD ; Brosh, David, MD ; Teplitsky, Igal, MD ; Bental, Tamir, MD ; Battler, Alexander, MD ; Kornowski, Ran, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c478t-bdbd86ea9dc67f1ce437f8894d0bf6dd94ddca8f38b9b18152435cb0300db2973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Angioplasty, Balloon, Coronary</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Coronary heart disease</topic><topic>Coronary Stenosis - mortality</topic><topic>Coronary Stenosis - therapy</topic><topic>Coronary Thrombosis - epidemiology</topic><topic>Diabetes Mellitus - epidemiology</topic><topic>Drug-Eluting Stents</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Myocardial Infarction - mortality</topic><topic>Myocardial Infarction - therapy</topic><topic>Myocarditis. Cardiomyopathies</topic><topic>Platelet Glycoprotein GPIIb-IIIa Complex - therapeutic use</topic><topic>Propensity Score</topic><topic>Prospective Studies</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. 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This prospective registry-based study included 1,569 consecutive unselected patients with STEMIs who underwent emergency primary percutaneous coronary intervention from January 2001 to December 2009. Of the study cohort, 200 patients (12.7%) received DES, while 1,369 patients (87.3%) underwent bare-metal stent (BMS) placement. The primary end points of the study were all-cause mortality and target vessel revascularization at 1, 2, and 3 years. Survival status was assessed by municipal civil registries. Repeat revascularization procedures were prospectively collected in the hospital database. All-cause mortality was significantly lower in the DES group at 3 years (4.2% vs 13.5%, p = 0.007) compared to BMS-treated patients, but DES use was not an independent predictor of all-cause mortality (adjusted odds ratio 0.5, 95% confidence interval 0.2 to 1.2, p = 0.10). Target vessel revascularization was significantly lower in the DES group compared to the BMS group at 3 years (10.5% vs 21%, p = 0.001). DES use was an independent predictor of reduced target vessel revascularization (adjusted odds ratio 0.44, 95% confidence interval 0.25 to 0.77, p = 0.004). Late definite stent thrombosis occurring after 1 year occurred in 4 (2.5%) patients in the DES group compared to 6 (0.7%) in the BMS group (p = 0.05). DES use was an independent predictor of late stent thrombosis (adjusted odds ratio 8.6, 95% confidence interval 1.9 to 38, p = 0.004). In conclusion, this contemporary registry-based study of patients who underwent primary percutaneous coronary intervention for STEMI demonstrated improved revascularization rates without increased 3-year hazard of adverse clinical outcomes in DES-treated patients.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>22440117</pmid><doi>10.1016/j.amjcard.2012.01.378</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
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| subjects | Angioplasty, Balloon, Coronary Biological and medical sciences Cardiology. Vascular system Cardiovascular Cardiovascular disease Coronary heart disease Coronary Stenosis - mortality Coronary Stenosis - therapy Coronary Thrombosis - epidemiology Diabetes Mellitus - epidemiology Drug-Eluting Stents Female Follow-Up Studies Heart Heart attacks Humans Male Medical sciences Middle Aged Mortality Multivariate Analysis Myocardial Infarction - mortality Myocardial Infarction - therapy Myocarditis. Cardiomyopathies Platelet Glycoprotein GPIIb-IIIa Complex - therapeutic use Propensity Score Prospective Studies Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Recurrence Registries Renal Insufficiency - epidemiology Retreatment Stents Thrombosis |
| title | Comparison of Late (3-Year) Registry Data Outcomes Using Bare Metal Versus Drug-Eluting Stents for Treating ST-Segment Elevation Acute Myocardial Infarctions |
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