Long-Term Safety and Efficacy of Sirolimus- and Paclitaxel-Eluting Stents in Patients With Acute Myocardial Infarction: Four-Year Observational Study

Abstract

Background and ObjectivesThe comparison of long-term clinical effects between Sirolimus-eluting stent (SES) and Paclitaxel-eluting stents (PES) for treatment of acute myocardial infarction (AMI) remains unclear. Seeking to clarify this issue, we performed a retrospective analysis to evaluate four-year clinical outcomes of SES compared to PES treated AMI patients.Subjects and MethodsFrom January 2004 to August 2006, all patients with acute ST-segment elevation myocardial infarction and acute non-ST segment elevation myocardial infarction who underwent percutaneous coronary intervention (PCI) by implantation of either SES or PES were enrolled. The occurrences of cardiac and non-cardiac deaths, recurrent infarction, target vessel revascularization (TVR) and stent thrombosis were analyzed. The composite end points of these major adverse cardiac events (MACE) were also analyzed.ResultsDuring the study period, a total of 668 AMI patients had visited, of which 522 patients (299 with SES and 223 with PES) were enrolled. During the four-year clinical follow-up, both groups showed similar occurrences of non-cardiac death (14.6±2.2% vs. 18.3±3.0%, p=0.26); cardiac death (6.8±1.52% vs. 11.2±2.6%, p=0.39); re-infarction (3.3±1.1% vs. 6.4±1.8%, p=0.31); and stent thrombosis (3.2±1.1% vs. 5.4±1.7%, p=0.53). However, occurrences of TVR {4.0±1.2% vs. 10.0±3.0%, hazard ratio (HR)=0.498, 95% confidence interval (CI)=0.257-0.967, p=0.039} and MACE (19.4±2.5% vs. 29.4±3.5%, HR=0.645, 95% CI=0.443-0.940, p=0.021) were significantly lower in the SES population.ConclusionIn AMI patients treated with either SES or PES implantation, the former had a significantly lower risk of TVR and MACE during four-year clinical follow-up. Rates of death, cardiac death or recurrent infarction, and stent thrombosis were similar.

Histopathological Comparison among Biolimus, Zotarolimus and Everolimus-Eluting Stents in Porcine Coronary Restenosis Model

“… 1) The introduction of drug eluting stents (DES) has provided improved clinical outcomes compared to the use of bare metal stents (BMS), by reducing neointimal hyperplasia and target vessel revascularizations. 2) 3) …”

Optical coherence tomography for evaluating Synergy everolimus-eluting stents with biodegradable polymer and Xience durable polymer everolimus-eluting stents following percutaneous coronary intervention in patients with left main coronary artery stenosis

“…В то же время имеются крупные рандомизированные исследования, демонстрирующие результаты профилей заживления стентов разных поколений. Внедрение стентов с ле-карственным покрытием улучшило клинические ре-зультаты по сравнению с использованием непокрытых стентов, уменьшая неоинтимальную гиперплазию и частоту реваскуляризации целевой артерии [27,28]. По данным ОКТ-анализа групп исследования RESOLUTE All Comers, через 13 мес.…”