title: The efficacy of everolimus-eluting stent implantation in patients with ST-segment elevation myocardial infarction: outcomes of 2-year clinical follow-up.
abstract: First-generation drug-eluting stents (DES) demonstrated delay in vascular healing and increase in incidence of late and very late stent thrombosis compared with bare-metal stents (BMS). Second-generation DES, however, have shown a reduction of late and very late stent thrombosis compared with first-generation DES. Thus, we decided to evaluate whether the second-generation everolimus-eluting stent (EES) has an advantage over BMS in Japanese patients with ST-segment elevation myocardial infarction (STEMI). This study was conducted in two centers, retrospective, non-randomized and observational design in patients with STEMI. Three-hundred eighty patients were randomly selected to receive EES (198 patients) or cobalt-chromium BMS (182 patients). The primary endpoints were cardiac death, recurrent myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), and stent thrombosis (ST). At 2 years, the rates of TLR, TVR, and recurrent MI were significantly lower in the EES group than in the BMS group (TLR 1.5 vs. 8.3 %, p < 0.05; TVR 2.5 vs. 9.4 %, p < 0.05; recurrent MI 1.0 vs. 4.1 %, p < 0.05), and the rate of ST was also significantly lower in the EES group than in the BMS group (0.5 vs. 4.3 %, p < 0.05). Thus, major adverse cardiac events defined at the composite cardiac death, MI, TLR, TVR, or ST were significantly lower in EES group than in BMS group (3.0 vs. 9.9 %, p = 0.008). The rate of cardiac death, however, did not differ between both groups. In STEMI patients, EES may be associated with improved outcomes-specifically, a significant reduction in TVR, ST, and recurrent MI compared to BMS throughout 2 years.
authors.affiliation: Department of Cardiology, Nasu Red Cross Hospital, Ohtawara, Tochigi, 324-8686, Japan. h.yano@nasu.jrc.or.jp.|Department of Cardiology and Nephrology, Dokkyo Medical University, Mibu, Tochigi, 321-0293, Japan. h.yano@nasu.jrc.or.jp.
authors.forename: Hideki
authors.initials: H
authors.lastname: Yano
authors.affiliation: Department of Cardiology, Nasu Red Cross Hospital, Ohtawara, Tochigi, 324-8686, Japan.|Department of Cardiology and Nephrology, Dokkyo Medical University, Mibu, Tochigi, 321-0293, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Horinaka
authors.affiliation: Department of Cardiology, Nasu Red Cross Hospital, Ohtawara, Tochigi, 324-8686, Japan.|Department of Cardiology and Nephrology, Dokkyo Medical University, Mibu, Tochigi, 321-0293, Japan.
authors.forename: Mayuko
authors.initials: M
authors.lastname: Ishikawa
authors.affiliation: Department of Cardiology, Nasu Red Cross Hospital, Ohtawara, Tochigi, 324-8686, Japan.|Department of Cardiology and Nephrology, Dokkyo Medical University, Mibu, Tochigi, 321-0293, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ishimitsu
mesh_terms: D000368:Aged; D002317:Cardiovascular Agents / Q000494:pharmacology*; D003328:Coronary Thrombosis / Q000209:etiology; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000494:pharmacology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011474:Prosthesis Design; D012189:Retrospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D000068338:Everolimus
keywords: Everolimus-eluting stent; Major adverse cardiac events; ST-segment elevation myocardial infarction