Publication:
Comparison of Newer-Generation Drug-Eluting With Bare-Metal Stents in Patients With Acute ST-Segment Elevation Myocardial Infarction: A Pooled Analysis of the EXAMINATION (clinical Evaluation of the Xience-V stent in Acute Myocardial INfArcTION) and COMFORTABLE-AMI (Comparison of Biolimus Eluted From an Erodible Stent Coating With Bare Metal Stents in Acute ST-Elevation Myocardial Infarction) Trials

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cris.virtualsource.author-orcid101f1394-72d5-4dda-b28f-666a3dee6c70
dc.contributor.authorSabaté, Manel
dc.contributor.authorRäber, Lorenz
dc.contributor.authorHeg, Dierik Hans
dc.contributor.authorBrugaletta, Salvatore
dc.contributor.authorKelbaek, Henning
dc.contributor.authorCequier, Angel
dc.contributor.authorOstojic, Miodrag
dc.contributor.authorIñiguez, Andrés
dc.contributor.authorTüller, David
dc.contributor.authorSerra, Antonio
dc.contributor.authorBaumbach, Andreas
dc.contributor.authorvon Birgelen, Clemens
dc.contributor.authorHernandez-Antolin, Rosana
dc.contributor.authorRoffi, Marco
dc.contributor.authorMainar, Vicente
dc.contributor.authorValgimigli, Marco
dc.contributor.authorSerruys, Patrick W
dc.contributor.authorJüni, Peter
dc.contributor.authorWindecker, Stephan
dc.date.accessioned2024-10-14T15:54:41Z
dc.date.available2024-10-14T15:54:41Z
dc.date.issued2014-01
dc.description.abstractOBJECTIVES This study sought to study the efficacy and safety of newer-generation drug-eluting stents (DES) compared with bare-metal stents (BMS) in an appropriately powered population of patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND Among patients with STEMI, early generation DES improved efficacy but not safety compared with BMS. Newer-generation DES, everolimus-eluting stents, and biolimus A9-eluting stents, have been shown to improve clinical outcomes compared with early generation DES. METHODS Individual patient data for 2,665 STEMI patients enrolled in 2 large-scale randomized clinical trials comparing newer-generation DES with BMS were pooled: 1,326 patients received a newer-generation DES (everolimus-eluting stent or biolimus A9-eluting stent), whereas the remaining 1,329 patients received a BMS. Random-effects models were used to assess differences between the 2 groups for the device-oriented composite endpoint of cardiac death, target-vessel reinfarction, and target-lesion revascularization and the patient-oriented composite endpoint of all-cause death, any infarction, and any revascularization at 1 year. RESULTS Newer-generation DES substantially reduce the risk of the device-oriented composite endpoint compared with BMS at 1 year (relative risk [RR]: 0.58; 95% confidence interval [CI]: 0.43 to 0.79; p = 0.0004). Similarly, the risk of the patient-oriented composite endpoint was lower with newer-generation DES than BMS (RR: 0.78; 95% CI: 0.63 to 0.96; p = 0.02). Differences in favor of newer-generation DES were driven by both a lower risk of repeat revascularization of the target lesion (RR: 0.33; 95% CI: 0.20 to 0.52; p < 0.0001) and a lower risk of target-vessel infarction (RR: 0.36; 95% CI: 0.14 to 0.92; p = 0.03). Newer-generation DES also reduced the risk of definite stent thrombosis (RR: 0.35; 95% CI: 0.16 to 0.75; p = 0.006) compared with BMS. CONCLUSIONS Among patients with STEMI, newer-generation DES improve safety and efficacy compared with BMS throughout 1 year. It remains to be determined whether the differences in favor of newer-generation DES are sustained during long-term follow-up.
dc.description.numberOfPages9
dc.description.sponsorshipInstitut für Sozial- und Präventivmedizin (ISPM)
dc.description.sponsorshipUniversitätsklinik für Kardiologie
dc.description.sponsorshipDepartement Klinische Forschung, Core Facility, Clinical Trials Unit (CTU) Bern
dc.identifier.doi10.7892/boris.41111
dc.identifier.pmid24332419
dc.identifier.publisherDOI10.1016/j.jcin.2013.07.012
dc.identifier.urihttps://boris-portal.unibe.ch/handle/20.500.12422/113110
dc.language.isoen
dc.publisherElsevier
dc.relation.ispartofJACC. Cardiovascular Interventions
dc.relation.issn1876-7605
dc.relation.organizationDCD5A442BE42E17DE0405C82790C4DE2
dc.relation.organizationDCD5A442C26DE17DE0405C82790C4DE2
dc.relation.organizationDCD5A442BB15E17DE0405C82790C4DE2
dc.relation.organizationDCD5A442BECFE17DE0405C82790C4DE2
dc.subjectBES BMS CI DES DOCE EES HR POCE RR ST-segment elevation myocardial infarction STEMI bare-metal stent(s) biolimus A9–eluting stent(s) confidence interval device-oriented composite endpoint drug-eluting stent(s) everolimus-eluting stent(s) hazard ratio patient-oriented composite endpoint relative risk stent thrombosis
dc.subject.ddc600 - Technology::610 - Medicine & health
dc.subject.ddc300 - Social sciences, sociology & anthropology::360 - Social problems & social services
dc.titleComparison of Newer-Generation Drug-Eluting With Bare-Metal Stents in Patients With Acute ST-Segment Elevation Myocardial Infarction: A Pooled Analysis of the EXAMINATION (clinical Evaluation of the Xience-V stent in Acute Myocardial INfArcTION) and COMFORTABLE-AMI (Comparison of Biolimus Eluted From an Erodible Stent Coating With Bare Metal Stents in Acute ST-Elevation Myocardial Infarction) Trials
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oaire.citation.endPage63
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oaire.citation.volume7
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oairecerif.author.affiliationUniversitätsklinik für Kardiologie
oairecerif.author.affiliationDepartement Klinische Forschung, Core Facility, Clinical Trials Unit (CTU) Bern
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oairecerif.author.affiliationInstitut für Sozial- und Präventivmedizin (ISPM)
oairecerif.author.affiliationUniversitätsklinik für Kardiologie
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oairecerif.author.affiliation2DKF CTU Bern
oairecerif.author.affiliation2Departement Klinische Forschung, Forschungsgruppe Kardiologie
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