title: Comparison of paclitaxel and everolimus-eluting stents in ST-segment elevation myocardial infarction and influence of thrombectomy on outcomes. ESTROFA-IM study.
abstract: OBJECTIVE
  We sought to compare the long-term clinical outcome of with ST-segment elevation myocardial infarction treated with paclitaxel-eluting stents or everolimus-eluting stents and the influence of thrombectomy on outcomes.
  
  
  METHODS
  The ESTROFA-IM is a multicenter retrospective registry collecting consecutive patients with infarction treated with these stents in 16 centers. Propensity-score matching was performed to select comparable stent groups and comparable groups with and without thrombectomy.
  
  
  RESULTS
  After matching patients, 350 treated with everolimus-eluting stents and 350 with paclitaxel-eluting stents were included in the analysis. The clinical and angiographic characteristics were comparable in both groups. The 2-year incidence of death, infarction, and target lesion revascularization was 14.9% for paclitaxel-eluting stents and 11.5% for everolimus-eluting stents (P = .04) and the incidence of definite/probable thrombosis 4.3% and 1.4%, respectively (P = .01). The use of paclitaxel-eluting was an independent predictor for events (hazard ratio = 2.44, 95% confidence interval, 1.28-4.65; P = .006). The benefit of everolimus-eluting stents over paclitaxel-eluting stents regarding stent thrombosis was more evident in the nonthrombectomy subgroup (5.4% vs 1.4%; P = .01). A significant interaction was found in the subgroups with and without thombectomy in the comparison between paclitaxel-eluting stents and everolimus-eluting stents for the end-point of stent thrombosis (P = .039).
  
  
  CONCLUSIONS
  The results of this multicenter registry suggest better clinical outcomes with the everolimus-eluting stents in ST-segment elevation myocardial infarction. The lower risk of thrombosis with these stents could be more relevant in the absence of thrombectomy.
authors.affiliation: Servicio de Cardiología, Hospital Marqués de Valdecilla, Santander, Cantabria, Spain. Electronic address: he1thj@humv.es.
authors.forename: José M
authors.initials: JM
authors.lastname: de la Torre Hernández
authors.affiliation: Servicio de Cardiología, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Alfonso
authors.affiliation: Servicio de Cardiología, Hospital Clínic, Barcelona, Spain.
authors.forename: Victoria
authors.initials: V
authors.lastname: Martin Yuste
authors.affiliation: Servicio de Cardiología, Hospital La Paz, Madrid, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Sánchez Recalde
authors.affiliation: Servicio de Cardiología, Hospital Virgen de la Victoria, Malaga, Spain.
authors.forename: Manuel F
authors.initials: MF
authors.lastname: Jimenez Navarro
authors.affiliation: Servicio de Cardiología, Hospital de León, León, Spain.
authors.forename: Armando
authors.initials: A
authors.lastname: Pérez de Prado
authors.affiliation: Servicio de Cardiología, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Felipe
authors.initials: F
authors.lastname: Hernández
authors.affiliation: Servicio de Cardiología, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Omar
authors.initials: O
authors.lastname: Abdul-Jawad Altisent
authors.affiliation: Servicio de Cardiología, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Gerard
authors.initials: G
authors.lastname: Roura
authors.affiliation: Servicio de Cardiología, Hospital Marqués de Valdecilla, Santander, Cantabria, Spain.
authors.forename: Tamara
authors.initials: T
authors.lastname: García Camarero
authors.affiliation: Servicio de Cardiología, Hospital Gregorio Marañon, Madrid, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Elizaga
authors.affiliation: Servicio de Cardiología, Hospital de la Coruña, CHUAC, La Coruña, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Calviño
authors.affiliation: Servicio de Cardiología, Hospital Virgen de la Salud, Toledo, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Moreu
authors.affiliation: Servicio de Cardiología, Hospital Clínico de Tenerife, Santa Cruz de Tenerife, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Bosa
authors.affiliation: Servicio de Cardiología, Hospital de Albacete, Albacete, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Jimenez Mazuecos
authors.affiliation: Servicio de Cardiología, Hospital Clínico Lozano Blesa, Zaragoza, Spain.
authors.forename: José R
authors.initials: JR
authors.lastname: Ruiz-Arroyo
authors.affiliation: Servicio de Cardiología, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Bruno
authors.initials: B
authors.lastname: Garcia Del Blanco
authors.affiliation: Servicio de Cardiología, Hospital de Galdakao, Bilbao, Vizcaya, Spain.
authors.forename: José R
authors.initials: JR
authors.lastname: Rumoso
mesh_terms: D001807:Blood Vessel Prosthesis; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery*; D017239:Paclitaxel / Q000627:therapeutic use*; D057216:Propensity Score; D012042:Registries; D012189:Retrospective Studies; D017131:Thrombectomy / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000068338:Everolimus; D017239:Paclitaxel
keywords: Drug-eluting stents; Infarto de miocardio; Myocardial infarction; Stents liberadores de fármacos; Thrombectomy; Trombectomía