title: Pooled analysis of two randomized trials comparing titanium-nitride-oxide-coated stent versus drug-eluting stent in STEMI.
abstract: OBJECTIVE
  We performed a pooled analysis based on patient-level data from the TITAX-AMI and BASE-ACS trials to evaluate the outcome of titanium-nitride-oxide-coated bioactive stents vs drug-eluting stents in patients with ST-segment elevation myocardial infarction at 2-year follow-up.
  
  
  METHODS
  The TITAX-AMI trial compared bioactive stents with paclitaxel-eluting stents in 425 patients with acute myocardial infarction. The BASE-ACS trial compared bioactive stents with everolimus-eluting stents in 827 patients with acute coronary syndrome. The primary endpoint for the pooled analysis was major adverse cardiac events: a composite of cardiac death, recurrent myocardial infarction, or ischemia-driven target lesion revascularization at 2-year follow-up.
  
  
  RESULTS
  The pooled analysis included 501 patients; 245 received bioactive stents, and 256 received drug-eluting stents. The pooled bioactive stent group was associated with a risk ratio of 0.85 for major adverse cardiac events (95% confidence interval, 0.53-1.35; P=.49) compared to the pooled drug-eluting stent group. Similarly, the pooled bioactive stent group was associated with a risk ratio of 0.71 for cardiac death (95% confidence interval, 0.26-1.95; P=.51), 0.44 for recurrent myocardial infarction (95% confidence interval, 0.20-0.97; P=.04), and 1.39 for ischemia-driven target lesion revascularization (95% confidence interval, 0.74-2.59; P=.30), compared to the pooled drug-eluting stent group. These results were confirmed by propensity-score adjusted analysis of the combined datasets.
  
  
  CONCLUSIONS
  In patients with ST-segment elevation myocardial infarction, bioactive stents were associated with lower rates of recurrent myocardial infarction compared to drug-eluting stents at 2-year follow-up; yet, the rates of cardiac death and ischemia-driven target lesion revascularization were similar.
authors: Department of Internal Medicine and Heart Center, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland; Department of Cardiology, Satakunta Central Hospital, Pori, Finland.
authors: Petri O
authors: PO
authors: Tuomainen
authors: Department of Cardiology, Kokkola Central Hospital, Kokkola, Finland.
authors: Jussi
authors: J
authors: Sia
authors: Department of Cardiology, Satakunta Central Hospital, Pori, Finland.
authors: Wail
authors: W
authors: Nammas
authors: Department of Internal Medicine, Division of Cardiology, University of Oulu, Oulu, Finland.
authors: Matti
authors: M
authors: Niemelä
authors: Department of Medicine, Turku University Hospital, Turku, Finland.
authors: Juhani K E
authors: JK
authors: Airaksinen
authors: Division of Cardiothoracic and Vascular Surgery, Department of Surgery, Oulu, Finland.
authors: Fausto
authors: F
authors: Biancari
authors: Department of Cardiology, Satakunta Central Hospital, Pori, Finland. Electronic address: pasi.karjalainen@satshp.fi.
authors: Pasi P
authors: PP
authors: Karjalainen
mesh_terms: D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000601:surgery*; D057216:Propensity Score; D012008:Recurrence; D014025:Titanium / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: C434243:titanium-nitride-oxide; D014025:Titanium
keywords: Bioactive stents; Everolimus-eluting stents; Infarto agudo de miocardio con elevación del segmento ST; Outcome; Paclitaxel-eluting stents; Resultados clínicos; ST-segment elevation myocardial infarction; Stents bioactivos; Stents liberadores de everolimus; Stents liberadores de paclitaxel