title: Five-year clinical outcome of titanium-nitride-oxide-coated bioactive stents versus paclitaxel-eluting stents in patients with acute myocardial infarction: long-term follow-up from the TITAX AMI trial.
abstract: BACKGROUND
  The TITAX-AMI randomized controlled trial demonstrated a better clinical outcome with titanium-nitride-oxide-coated bioactive stents (BAS) as compared with paclitaxel-eluting stents (PES) at 2-year follow-up, in patients with acute myocardial infarction (MI) undergoing early percutaneous coronary intervention (PCI). We sought to present the 5-year clinical outcome of the TITAX-AMI trial.
  
  
  METHODS
  A total of 425 patients with acute MI were randomly assigned to receive either BAS (214), or PES (211). The primary endpoint was major adverse cardiac events (MACE): a composite of cardiac death, recurrent MI or ischemia-driven target lesion revascularization (TLR). Clinical follow-up was performed to 5 years.
  
  
  RESULTS
  The 5-year cumulative incidence of MACE was significantly lower in patients assigned to BAS as compared with those assigned to PES (16.4% versus 25.1%, respectively, p=0.03). Similarly, the 5-year rates of cardiac death and recurrent MI were significantly lower in patients assigned to BAS (1.9% versus 5.7%, and 8.4% versus 18.0%, p=0.04 and p=0.004, respectively). Yet, the rates of ischemia-driven TLR were similar between the two study groups (11.2% versus 10.9%, respectively, p=0.92). The rate of definite stent thrombosis (ST) was again significantly lower in patients assigned to BAS (0.9% versus 7.1%, respectively, p=0.001).
  
  
  CONCLUSIONS
  In the current prospective randomized TITAX-AMI trial, among patients presenting with acute MI who underwent early PCI, BAS achieved a better clinical outcome as compared with PES at 5-year follow-up, as reflected by lower cumulative rates of overall MACE, cardiac death, recurrent MI, and definite ST; yet, with statistically similar rates of ischemia-driven TLR.
authors.affiliation: Heart Center, Satakunta Central Hospital, Pori, Finland; Department of Internal Medicine and Heart Center, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.
authors.forename: Petri O
authors.initials: PO
authors.lastname: Tuomainen
authors.forename: Antti
authors.initials: A
authors.lastname: Ylitalo
authors.forename: Matti
authors.initials: M
authors.lastname: Niemelä
authors.forename: Kari
authors.initials: K
authors.lastname: Kervinen
authors.forename: Mikko
authors.initials: M
authors.lastname: Pietilä
authors.forename: Jussi
authors.initials: J
authors.lastname: Sia
authors.forename: Kai
authors.initials: K
authors.lastname: Nyman
authors.forename: Wail
authors.initials: W
authors.lastname: Nammas
authors.forename: K E Juhani
authors.initials: KE
authors.lastname: Airaksinen
authors.forename: Pasi P
authors.initials: PP
authors.lastname: Karjalainen
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003643:Death; D054855:Drug-Eluting Stents / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D017239:Paclitaxel / Q000008:administration & dosage*; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation / Q000639:trends*; D011446:Prospective Studies; D016037:Single-Blind Method; D013997:Time Factors; D014025:Titanium / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: C434243:titanium-nitride-oxide; D014025:Titanium; D017239:Paclitaxel