Biolimus-eluting stent with biodegradable polymer improves clinical outcomes in patients with acute myocardial infarction


Autoria(s): Zhang, Yao-Jun; Iqbal, Javaid; Windecker, Stephan; Linke, Axel; Antoni, Diethmar; Sohn, Hae Young; Corti, Roberto; van Es, Gerrit-Anne; Copt, Samuel; Eerdmans, Pedro; Saitta, Rana; Morice, Marie-Claude; Di Mario, Carlo; Jüni, Peter; Wijns, William; Buszman, Pawel; Serruys, Patrick W
Data(s)

2015

Resumo

OBJECTIVE To investigate clinical outcomes of coronary intervention using a biolimus-eluting stent (BES) compared with a sirolimus-eluting stent (SES) in patients with acute myocardial infarction (AMI) in the Limus Eluted from A Durable versus ERodable Stent (LEADERS) coating trial at the final 5-year follow-up. METHODS The LEADERS trial is a multicentre all-comer study, where patients (n=1707) were randomised to percutaneous intervention with either BES containing biodegradable polymer or SES containing durable polymer. Out of 1707 patients enrolled in this trial, 573 patients had percutaneous coronary intervention for AMI (BES=280, SES=293) and were included in the current analysis. Patient-oriented composite endpoint (POCE, including all death, all myocardial infarction (MI) and all revascularisations), major adverse cardiac events (MACE, including cardiac death, MI and clinically indicated target vessel revascularisation) and stent thrombosis were assessed at 5-year follow-up. RESULTS The baseline clinical, angiographic and procedural characteristics were well matched between BES and SES groups. In all patients with AMI, coronary intervention with a BES, compared with SES, significantly reduced POCE (28.9% vs 42.3%; relative risk (RR) 0.61, 95% CI 0.47 to 0.82, p=0.001) at 5-year follow-up. There was also a reduction in MACE rate in the BES group (18.2% vs 25.9%; RR 0.67, 95% CI 0.47 to 0.95, p=0.025); however, there was no difference in cardiac death and stent thrombosis. In patients with ST-elevation MI (STEMI), coronary intervention with BES significantly reduced POCE (24.4% vs 39.3%; RR 0.55, 95% CI 0.36 to 0.85, p=0.006), MACE (12.6% vs 25.0%; RR 0.47, 95% CI 0.26 to 0.83, p=0.008) and cardiac death (3.0% vs 11.4%; RR 0.25, 95% CI 0.08 to 0.75, p=0.007), along with a trend towards reduction in definite stent thrombosis (3.7% vs 8.6%; RR 0.41, 95% CI 0.15 to 1.18, p=0.088), compared with SES. CONCLUSIONS BES, compared with SES, significantly improved safety and efficacy outcomes in patients with AMI, especially those with STEMI, at 5-year follow-up. TRIAL REGISTRATION NUMBER NCT 00389220.

Formato

application/pdf

Identificador

http://boris.unibe.ch/61444/7/Zhang%20Heart%202015.pdf

Zhang, Yao-Jun; Iqbal, Javaid; Windecker, Stephan; Linke, Axel; Antoni, Diethmar; Sohn, Hae Young; Corti, Roberto; van Es, Gerrit-Anne; Copt, Samuel; Eerdmans, Pedro; Saitta, Rana; Morice, Marie-Claude; Di Mario, Carlo; Jüni, Peter; Wijns, William; Buszman, Pawel; Serruys, Patrick W (2015). Biolimus-eluting stent with biodegradable polymer improves clinical outcomes in patients with acute myocardial infarction. Heart (British Cardiac Society), 101(4), pp. 271-8. BMJ Publishing Group 10.1136/heartjnl-2014-306359 <http://dx.doi.org/10.1136/heartjnl-2014-306359>

doi:10.7892/boris.61444

info:doi:10.1136/heartjnl-2014-306359

info:pmid:25423953

urn:issn:1468-201X

Idioma(s)

eng

Publicador

BMJ Publishing Group

Relação

http://boris.unibe.ch/61444/

Direitos

info:eu-repo/semantics/restrictedAccess

Fonte

Zhang, Yao-Jun; Iqbal, Javaid; Windecker, Stephan; Linke, Axel; Antoni, Diethmar; Sohn, Hae Young; Corti, Roberto; van Es, Gerrit-Anne; Copt, Samuel; Eerdmans, Pedro; Saitta, Rana; Morice, Marie-Claude; Di Mario, Carlo; Jüni, Peter; Wijns, William; Buszman, Pawel; Serruys, Patrick W (2015). Biolimus-eluting stent with biodegradable polymer improves clinical outcomes in patients with acute myocardial infarction. Heart (British Cardiac Society), 101(4), pp. 271-8. BMJ Publishing Group 10.1136/heartjnl-2014-306359 <http://dx.doi.org/10.1136/heartjnl-2014-306359>

Palavras-Chave #610 Medicine & health #360 Social problems & social services
Tipo

info:eu-repo/semantics/article

info:eu-repo/semantics/publishedVersion

PeerReviewed