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Biolimus-eluting stent with biodegradable polymer improves clinical outcomes in patients with acute myocardial infarction.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Zhang, Yao-jun Iqbal, Javaid Windecker, Stephan Linke, Angelika Antoni, Diethmar Sohn, Hae Young Corti, Roberto Es, Gerrit-Anne Van Copt, Samuel Eerdmans, Pedro Saitta, Rana Morice, M. C. Mario, Carlo Di Jűni, Peter Wijns, William Buszman, Paweł E. Serruys, Patrick W. |
| Copyright Year | 2015 |
| Abstract | OBJECTIVE To investigate clinical outcomes of coronary intervention using a biolimus-eluting stent (BES) compared with a sirolimus-eluting stent (SES) in patients with acute myocardial infarction (AMI) in the Limus Eluted from A Durable versus ERodable Stent (LEADERS) coating trial at the final 5-year follow-up. METHODS The LEADERS trial is a multicentre all-comer study, where patients (n=1707) were randomised to percutaneous intervention with either BES containing biodegradable polymer or SES containing durable polymer. Out of 1707 patients enrolled in this trial, 573 patients had percutaneous coronary intervention for AMI (BES=280, SES=293) and were included in the current analysis. Patient-oriented composite endpoint (POCE, including all death, all myocardial infarction (MI) and all revascularisations), major adverse cardiac events (MACE, including cardiac death, MI and clinically indicated target vessel revascularisation) and stent thrombosis were assessed at 5-year follow-up. RESULTS The baseline clinical, angiographic and procedural characteristics were well matched between BES and SES groups. In all patients with AMI, coronary intervention with a BES, compared with SES, significantly reduced POCE (28.9% vs 42.3%; relative risk (RR) 0.61, 95% CI 0.47 to 0.82, p=0.001) at 5-year follow-up. There was also a reduction in MACE rate in the BES group (18.2% vs 25.9%; RR 0.67, 95% CI 0.47 to 0.95, p=0.025); however, there was no difference in cardiac death and stent thrombosis. In patients with ST-elevation MI (STEMI), coronary intervention with BES significantly reduced POCE (24.4% vs 39.3%; RR 0.55, 95% CI 0.36 to 0.85, p=0.006), MACE (12.6% vs 25.0%; RR 0.47, 95% CI 0.26 to 0.83, p=0.008) and cardiac death (3.0% vs 11.4%; RR 0.25, 95% CI 0.08 to 0.75, p=0.007), along with a trend towards reduction in definite stent thrombosis (3.7% vs 8.6%; RR 0.41, 95% CI 0.15 to 1.18, p=0.088), compared with SES. CONCLUSIONS BES, compared with SES, significantly improved safety and efficacy outcomes in patients with AMI, especially those with STEMI, at 5-year follow-up. TRIAL REGISTRATION NUMBER NCT 00389220. |
| Starting Page | 8 |
| Ending Page | 13 |
| Page Count | 6 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://epub.ub.uni-muenchen.de/37248/1/271.full.pdf |
| PubMed reference number | 25423953v1 |
| Alternate Webpage(s) | https://doi.org/10.1136/heartjnl-2014-306359 |
| DOI | 10.1136/heartjnl-2014-306359 |
| Journal | Heart |
| Volume Number | 101 |
| Issue Number | 4 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Acute myocardial infarction Cardiac Death Cessation of life Coating Excipient Drug-Eluting Stents Follow-Up Report Mace Spice N,N-bis(2-hydroxyethyl)aminoethanesulfonic acid Patients Percutaneous Coronary Intervention Polymers ST segment elevation myocardial infarction Sirolimus Stent Device Component Stent, device Thrombosis revascularization |
| Content Type | Text |
| Resource Type | Article |
