Long-term results of the randomized comparison of everolimus-eluting stents and sirolimus-eluting stent in patients with ST elevation myocardial infarction (RACES-MI trial)

Emilio Di Lorenzo, Rosario Sauro, Michele Capasso, Francesca Lanni, Tonino Lanzillo, Giannignazio Carbone, Fiore Manganelli, Vittorio Palmieri, Vincenzo Serino, Maria Rosaria Pagliuca, Giuseppe Rosato, Harry Suryapranata, Giuseppe De Luca

Risultato della ricerca: Contributo su rivistaArticolo in rivistapeer review

Abstract

Background Several concerns have emerged about the higher risk of very late stent thrombosis (ST) with first generation drug-eluting stent (DES), especially in ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI). New generation DES have demonstrated reduction in ST at mid-term follow-up, however no data are available on long-term follow-up. Therefore, the aim of this study was to report long-term results of the RACES-MI trial conducted to compare Everolimus-Eluting Stent (EES) vs Sirolimus-Eluting Stent (SES) in patients undergoing primary PCI. Methods The RACES-MI trial enrolled consecutive STEMI patients admitted within 12 h of symptom onset, undergoing primary PCI with stent implantation at a tertiary center with 24-hour primary PCI capability, who were randomly assigned to SES or EES. Primary endpoint of this analysis is major adverse cardiac events (MACE) at long-term follow-up. Secondary endpoints are 1) death; 2) reinfarction; 3) definite or probable ST; 4) target-vessel revascularization (TVR) at long-term follow-up. Results From April 2007 to May 2009 500 patients with STEMI were randomized to EES (n = 250) or SES (n = 250). No difference was observed between the groups either in baseline clinical characteristics, in the number of implanted stent or total stent length per patient. However, a larger reference diameter was observed with SES (3.35 ± 0.51 mm vs 3.25 ± 0.51 mm, p = 0.001), whereas patients randomized to EES received Gp IIb-IIIa inhibitors more often (54.4% vs 42.4%, p = 0.006). At long-term follow-up (2132 ± 528 days), EES was associated with a significant reduction in MACE (23.8 vs 34.1%, adjusted p = 0.028), ST (2.5% vs 7.7%, adjusted p = 0.009), without any difference in death (8.7% vs 11.4%, adjusted p = 0.47), reMI (9.3% vs 13.1%; adjusted p = 0.18) and TVR (8.6% vs 12.3%, adjusted p = 0.31). Conclusions This study shows that among STEMI patients undergoing primary PCI EES, as compared to SES, is associated with significant reduction in MACE and ST at long-term follow-up.

Lingua originaleInglese
pagine (da-a)177-182
Numero di pagine6
RivistaInternational Journal of Cardiology
Volume202
DOI
Stato di pubblicazionePubblicato - 1 gen 2016
Pubblicato esternamente

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