title: The EXAMINATION trial (Everolimus-Eluting Stents Versus Bare-Metal Stents in ST-Segment Elevation Myocardial Infarction): 2-year results from a multicenter randomized controlled trial.
abstract: OBJECTIVE
  This study sought to assess the 2-year outcomes of the population included in the EXAMINATION (Everolimus-Eluting Stents Versus Bare-Metal Stents in ST-Segment Elevation Myocardial Infarction) trial beyond the 1-year prescription period of dual antiplatelet therapy.
  
  
  BACKGROUND
  The EXAMINATION trial compared the performance of everolimus-eluting stents (EES) versus bare-metal stents (BMS) in an all-comer ST-segment elevation myocardial infarction (STEMI) population.
  
  
  METHODS
  This was a multicenter, multinational, prospective, randomized, single-blind, controlled trial in patients with STEMI. The primary endpoint, which was the combined endpoint of all-cause death, any recurrent myocardial infarction, and any revascularization, and the endpoints target lesion revascularization and stent thrombosis were assessed at 2 years.
  
  
  RESULTS
  Between December 31, 2008, and May 15, 2010, 1,498 patients were randomized to receive EES (n = 751) or BMS (n = 747). Compliance with dual antiplatelet regimen was reduced at 2 years to a similar degree (17.3% vs. 17.2%, p = 0.91). At 2 years, the primary endpoint occurred in 108 (14.4%) patients of the EES group and in 129 (17.3%) patients of the BMS group (p = 0.11). Rate of target lesion revascularization was significantly lower in the EES group than in the BMS group (2.9% vs. 5.6%; p = 0.009). Rates of definite and definite or probable stent thrombosis were also significantly reduced in the EES group (0.8% vs. 2.1%; p = 0.03, and 1.3% vs. 2.8%; p = 0.04, respectively).
  
  
  CONCLUSIONS
  The 2-year follow-up of the EXAMINATION trial confirms the safety and efficacy of the EES compared with BMS in the setting of STEMI. Specifically, both rates of target lesion revascularization and stent thrombosis were reduced in recipients of EES without any signs of late attrition for either of these endpoints. (A Clinical Evaluation of Everolimus Eluting Coronary Stents in the Treatment of Patients With ST-Segment Elevation Myocardial Infarction: EXAMINATION Study; NCT00828087).
authors: University Hospital Clinic, IDIBAPS, Cardiology Department, Barcelona, Spain. Electronic address: masabate@clinic.ub.es.
authors: Manel
authors: M
authors: Sabaté
authors: University Hospital Clinic, IDIBAPS, Cardiology Department, Barcelona, Spain.
authors: Salvatore
authors: S
authors: Brugaletta
authors: University Hospital of Bellvitge, Interventional Cardiology Unit, Barcelona, Spain.
authors: Angel
authors: A
authors: Cequier
authors: Hospital do Meixoeiro, Interventional Cardiology Unit, Vigo, Spain.
authors: Andrés
authors: A
authors: Iñiguez
authors: University Hospital of Sant Pau, Interventional Cardiology Unit, Barcelona, Spain.
authors: Antonio
authors: A
authors: Serra
authors: University Hospital San Carlos, Interventional Cardiology Unit, Madrid, Spain.
authors: Rosana
authors: R
authors: Hernádez-Antolín
authors: Hospital General of Alicante, Interventional Cardiology Unit, Alicante, Spain.
authors: Vicente
authors: V
authors: Mainar
authors: University Hospital Ferrara, Interventional Cardiology Unit, Ferrara, Italy.
authors: Marco
authors: M
authors: Valgimigli
authors: University Hospital Bolognini Seriate, Interventional Cardiology Unit, Bergamo, Italy.
authors: Maurizio
authors: M
authors: Tespili
authors: Amphia Ziekenhuis, Interventional Cardiology Unit, Breda, the Netherlands.
authors: Pieter
authors: P
authors: den Heijer
authors: Hospital Son Espases, Interventional Cardiology Unit, Palma de Mallorca, Spain.
authors: Armando
authors: A
authors: Bethencourt
authors: Hospital Juan Canalejo, Interventional Cardiology Unit, A Coruña, Spain.
authors: Nicolás
authors: N
authors: Vázquez
authors: Erasmus Medical Center, Interventional Cardiology Unit, Rotterdam, the Netherlands.
authors: Bianca
authors: B
authors: Backx
authors: Cardialysis, Rotterdam, the Netherlands.
authors: Patrick W
authors: PW
authors: Serruys
mesh_terms: D000368:Aged; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D003328:Coronary Thrombosis / Q000209:etiology; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D054855:Drug-Eluting Stents; D005060:Europe; D000068338:Everolimus; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011446:Prospective Studies; D011474:Prosthesis Design; D012008:Recurrence; D016037:Single-Blind Method; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D010975:Platelet Aggregation Inhibitors; D000068338:Everolimus; D020123:Sirolimus
keywords: BMS; DES; EES; ST-segment elevation myocardial infarction; STEMI; bare-metal stent(s); drug-eluting stent(s); everolimus-eluting stent(s); myocardial infarction; revascularization; stent(s); thrombosis; trials