title: Impact of age on clinical outcomes after everolimus-eluting and paclitaxel-eluting stent implantation: pooled analysis from the SPIRIT III and SPIRIT IV clinical trials.
abstract: OBJECTIVE
  The impact of age on outcomes following everolimus-eluting stent (EES) or paclitaxel-eluting stent (PES) implantation was evaluated in a patient-level pooled analysis of the SPIRIT III (n=1,002) and SPIRIT IV (n=3,687) trials.
  
  
  RESULTS
  Clinical outcomes with EES compared to PES in elderly (≥ 65 years, n=2,071) and younger (<65 years, n=2,617) patients were evaluated at one year. At one year, elderly patients treated with EES rather than PES showed a significant reduction in target lesion failure (TLF) (3.9% EES vs. 6.8% PES, p=0.006), major adverse cardiac events (MACE) (4.0% EES vs. 7.1% PES, p=0.005), and ischaemia-driven target lesion revascularisation (ID-TLR) (2.0% EES vs. 4.0% PES, p=0.01). Younger patients treated with EES rather than PES also had significantly reduced one-year rates of TLF (4.9% EES vs. 7.9% PES, p=0.003), MACE (5.0% EES vs. 8.0% PES, p=0.004), target vessel myocardial infarction (MI) (2.0% EES vs. 3.4% PES, p=0.04), ID-TLR (3.3% EES vs. 5.5% PES, p=0.01) and stent thrombosis (0.5% EES vs. 1.6% PES, p=0.01).
  
  
  CONCLUSIONS
  In a pooled analysis from the SPIRIT III and IV trials, EES was safer and more effective than PES in both younger and older cohorts as evidenced by lower rates of TLR, TLF and MACE.
authors.affiliation: The Heart Center of Indiana, Indianapolis, IN 46290, USA. Herms2@gmail.com
authors.forename: James B
authors.initials: JB
authors.lastname: Hermiller
authors.forename: Krishnankutty
authors.initials: K
authors.lastname: Sudhir
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Applegate
authors.forename: Ali
authors.initials: A
authors.lastname: Rizvi
authors.forename: John
authors.initials: J
authors.lastname: Wang
authors.forename: Paul C
authors.initials: PC
authors.lastname: Gordon
authors.forename: Manejeh
authors.initials: M
authors.lastname: Yaqub
authors.forename: Sherry
authors.initials: S
authors.lastname: Cao
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Ferguson
authors.forename: Robert S
authors.initials: RS
authors.lastname: Smith
authors.forename: Poornima
authors.initials: P
authors.lastname: Sood
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
mesh_terms: D000367:Age Factors; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology / Q000517:prevention & control; D017239:Paclitaxel / Q000008:administration & dosage*; D011446:Prospective Studies; D011474:Prosthesis Design; D018570:Risk Assessment; D012307:Risk Factors; D016037:Single-Blind Method; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D000068338:Everolimus; D017239:Paclitaxel; D020123:Sirolimus