title: Everolimus- and sirolimus-eluting stents in patients with and without ST-segment elevation myocardial infarction.
abstract: OBJECTIVE
  Everolimus-eluting stents (EES) were superior to sirolimus-eluting stents (SES) in a dedicated myocardial infarction trial, a finding that was not observed in trials with low percentages of ST-elevation myocardial infarction (STEMI). Therefore, this study sought to investigate the influence of clinical presentation on outcome after EES and SES implantation.
  
  
  METHODS
  A pooled population of 1602 randomised patients was formed from XAMI (acute MI trial) and APPENDIX-AMI (all-comer trial). Primary outcome was cardiac mortality, MI and target vessel revascularisation at 2 years. Secondary endpoints included definite/probable stent thrombosis (ST). Adjustment was done using Cox regression.
  
  
  RESULTS
  In total, 902 EES and 700 SES patients were included, of which 44 % STEMI patients (EES 455; SES 257) and 56 % without STEMI (EES 447; SES 443). In the pooled population, EES and SES showed similar outcomes during follow-up. Moreover, no differences in the endpoints were observed after stratification according to presentation. Although a trend toward reduced early definite/probable ST was observed in EES compared with SES in STEMI patients, long-term ST rates were low and comparable.
  
  
  CONCLUSIONS
  EES and SES showed a similar outcome during 2-year follow-up, regardless of clinical presentation. Long-term safety was excellent for both devices, despite wide inclusion criteria and a large sub-population of STEMI patients.
authors: Department of Cardiology, Medical Center Leeuwarden, PO Box 888, 8901 BR, Leeuwarden, the Netherlands, m.a.velders@lumc.nl.
authors: M A
authors: MA
authors: Velders
authors: A J
authors: AJ
authors: van Boven
authors: J
authors: J
authors: Brouwer
authors: P C
authors: PC
authors: Smits
authors: A W J
authors: AW
authors: van 't Hof
authors: C J
authors: CJ
authors: de Vries
authors: M
authors: M
authors: Queré
authors: S H
authors: SH
authors: Hofma