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The efficacy of everolimus-eluting stent implantation in patients with ST-segment elevation myocardial infarction: outcomes of 2-year clinical follow-up

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Abstract

First-generation drug-eluting stents (DES) demonstrated delay in vascular healing and increase in incidence of late and very late stent thrombosis compared with bare-metal stents (BMS). Second-generation DES, however, have shown a reduction of late and very late stent thrombosis compared with first-generation DES. Thus, we decided to evaluate whether the second-generation everolimus-eluting stent (EES) has an advantage over BMS in Japanese patients with ST-segment elevation myocardial infarction (STEMI). This study was conducted in two centers, retrospective, non-randomized and observational design in patients with STEMI. Three-hundred eighty patients were randomly selected to receive EES (198 patients) or cobalt-chromium BMS (182 patients). The primary endpoints were cardiac death, recurrent myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), and stent thrombosis (ST). At 2 years, the rates of TLR, TVR, and recurrent MI were significantly lower in the EES group than in the BMS group (TLR 1.5 vs. 8.3 %, p < 0.05; TVR 2.5 vs. 9.4 %, p < 0.05; recurrent MI 1.0 vs. 4.1 %, p < 0.05), and the rate of ST was also significantly lower in the EES group than in the BMS group (0.5 vs. 4.3 %, p < 0.05). Thus, major adverse cardiac events defined at the composite cardiac death, MI, TLR, TVR, or ST were significantly lower in EES group than in BMS group (3.0 vs. 9.9 %, p = 0.008). The rate of cardiac death, however, did not differ between both groups. In STEMI patients, EES may be associated with improved outcomes—specifically, a significant reduction in TVR, ST, and recurrent MI compared to BMS throughout 2 years.

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Authors and Affiliations

  1. Department of Cardiology, Nasu Red Cross Hospital, Ohtawara, Tochigi, 324-8686, Japan

    Hideki Yano, Shigeo Horinaka, Mayuko Ishikawa & Toshihiko Ishimitsu

  2. Department of Cardiology and Nephrology, Dokkyo Medical University, Mibu, Tochigi, 321-0293, Japan

    Hideki Yano, Shigeo Horinaka, Mayuko Ishikawa & Toshihiko Ishimitsu

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  1. Hideki Yano
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  2. Shigeo Horinaka
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Correspondence to Hideki Yano.

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Yano, H., Horinaka, S., Ishikawa, M. et al. The efficacy of everolimus-eluting stent implantation in patients with ST-segment elevation myocardial infarction: outcomes of 2-year clinical follow-up. Heart Vessels 31, 1609–1615 (2016). https://doi.org/10.1007/s00380-015-0783-9

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