Outcome After Myocardial Infarction Treated With Resolute Integrity and Promus Element Stents: Insights From the DUTCH PEERS (TWENTE II) Randomized Trial.
OBJECTIVE
In acute myocardial infarction (MI), novel highly deliverable drug-eluting stents (DES) may be particularly valuable as their flexible stent designs might reduce device-induced traumas to culprit lesions. The aim of the study was to assess the safety and efficacy of percutaneous coronary interventions with 2 novel durable polymer-coated DES in patients with acute MI.


METHODS
The prospective, randomized DUTCH PEERS (TWENTE II) multicenter trial compares Resolute Integrity and Promus Element stents in 1811 all-comer patients, of whom 817 (45.1%) were treated for ST-segment elevation MI or non-ST-segment elevation MI and the 2-year outcome is available in 99.9%. The primary clinical endpoint is target vessel failure (TVF), a composite of cardiac death, target vessel related MI, or target vessel revascularization.


RESULTS
Of all 817 patients treated for acute MI, 421 (51.5%) were treated with Resolute Integrity and 396 (48.5%) with Promus Element stents. At the 2-year follow-up, the rates of TVF (7.4% vs 6.1%; P = .45), target lesion revascularization (3.1% vs 2.8%; P = .79), and definite stent thrombosis (1.0% vs 0.5%; P = .69) were low for both stent groups. Consistent with these findings in all patients with acute MI, outcomes for the 2 DES were favorable and similar in both, with 370 patients with ST-segment elevation MI (TVF, 5.1% vs 4.9%; P = .81) and 447 patients with non-ST-segment elevation MI (TVF, 9.0% vs 7.5%; P = .56).


CONCLUSIONS
Resolute Integrity and Promus Element stents were both safe and efficacious in treating patients with acute MI. The present 2-year follow-up data underline the safety of using these devices in this particular clinical setting.
Cardiology Department, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands.
K Gert
KG
van Houwelingen
Cardiology Department, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands.
Ming Kai
MK
Lam
Cardiology Department, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands.
Marije M
MM
Löwik
Cardiology Department, Rijnstate Hospital, Arnhem, The Netherlands.
Peter W
PW
Danse
Cardiology Department, Rijnstate Hospital, Arnhem, The Netherlands.
R Melvyn
RM
Tjon Joe Gin
Cardiology Department, Treant Zorggroep Location Scheper, Emmen, The Netherlands.
Gillian A
GA
Jessurun
Cardiology Department, Treant Zorggroep Location Scheper, Emmen, The Netherlands.
Rutger L
RL
Anthonio
Cardiology Department, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands.
Hanim
H
Sen
Cardiology Department, Ziekenhuisgroep Twente, Almelo and Hengelo, The Netherlands.
Gerard C M
GCM
Linssen
Department Health Technology and Services Research, MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
Maarten J
MJ
IJzerman
Department Health Technology and Services Research, MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
Carine J M
CJM
Doggen
Cardiology Department, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands; Department Health Technology and Services Research, MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands. Electronic address: c.vonbirgelen@mst.nl.
Clemens
C
von Birgelen
D000368:Aged; D000970:Antineoplastic Agents; D002318:Cardiovascular Diseases / Q000401:mortality; D017023:Coronary Angiography; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D006083:Graft Occlusion, Vascular / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000706:statistics & numerical data; D009426:Netherlands; D000072658:Non-ST Elevated Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D000072657:ST Elevation Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D020123:Sirolimus / Q000031:analogs & derivatives; D013927:Thrombosis / Q000453:epidemiology*
D000970:Antineoplastic Agents; D000068338:Everolimus; C489443:zotarolimus; D020123:Sirolimus
Acute coronary syndrome; Cobalt-chromium zotarolimus-eluting stent; DUTCH PEERS (TWENTE II) trial; Drug-eluting stent; Ensayo DUTCH PEERS (TWENTE II); Infarto de miocardio; Intervención coronaria percutánea; Myocardial infarction; Percutaneous coronary intervention; Platinum-chromium everolimus-eluting stent; Promus Element stent; Resolute Integrity stent; Stent Promus Element; Stent Resolute Integrity; Stent de cobalto-cromo liberador de zotarolimus; Stent de platino-cromo liberador de everolimus; Stent farmacoactivo; Síndrome coronario agudo