The EXAMINATION Trial (Everolimus-Eluting Stents Versus Bare-Metal Stents in ST-Segment Elevation Myocardial Infarction) 2-Year Results From a Multicenter Randomized Controlled Trial
Por:
Sabate, M, Brugaletta, S, Cequier, A, Iniguez, A, Serra, A, Hernadez-Antolin, R, Mainar, V, Valgimigli, M, Tespili, M, den Heijer, P, Bethencourt, A, Vazquez, N, Backx, B, Serruys, PW
Publicada:
1 ene 2014
Resumen:
Objectives This study sought to assess the 2-year outcomes of the population included in the EXAMINATION (Everolimus-Eluting Stents Versus Bare-Metal Stents in ST-Segment Elevation Myocardial Infarction) trial beyond the 1-year prescription period of dual antiplatelet therapy.
Background The EXAMINATION trial compared the performance of everolimus-eluting stents (EES) versus bare-metal stents (BMS) in an all-comer ST-segment elevation myocardial infarction (STEMI) population.
Methods This was a multicenter, multinational, prospective, randomized, single-blind, controlled trial in patients with STEMI. The primary endpoint, which was the combined endpoint of all-cause death, any recurrent myocardial infarction, and any revascularization, and the endpoints target lesion revascularization and stent thrombosis were assessed at 2 years. Results Between December 31, 2008, and May 15, 2010, 1,498 patients were randomized to receive EES (n = 751) or BMS (n = 747). Compliance with dual antiplatelet regimen was reduced at 2 years to a similar degree (17.3% vs. 17.2%, p = 0.91). At 2 years, the primary endpoint occurred in 108 (14.4%) patients of the EES group and in 129 (17.3%) patients of the BMS group (p = 0.11). Rate of target lesion revascularization was significantly lower in the EES group than in the BMS group (2.9% vs. 5.6%; p = 0.009). Rates of definite and definite or probable stent thrombosis were also significantly reduced in the EES group (0.8% vs. 2.1%; p = 0.03, and 1.3% vs. 2.8%; p 0.04, respectively).
Conclusions The 2-year follow-up of the EXAMINATION trial confirms the safety and efficacy of the EES compared with BMS in the setting of STEMI. Specifically, both rates of target lesion revascularization and stent thrombosis were reduced in recipients of EES without any signs of late attrition for either of these endpoints. (A Clinical Evaluation of Everolimus Eluting Coronary Stents in the Treatment of Patients With ST-Segment Elevation Myocardial Infarction: EXAMINATION Study; NCT00828087) (C) 2014 by the American College of Cardiology Foundation
Filiaciones:
Sabate, M:
IDIBAPS, Univ Hosp Clin, Dept Cardiol, Barcelona, Spain
Brugaletta, S:
IDIBAPS, Univ Hosp Clin, Dept Cardiol, Barcelona, Spain
Cequier, A:
Univ Hosp Bellvitge, Intervent Cardiol Unit, Barcelona, Spain
Iniguez, A:
Hosp Meixoeiro, Intervent Cardiol Unit, Vigo, Spain
Serra, A:
Univ Hosp Sant Pau, Intervent Cardiol Unit, Barcelona, Spain
Hernadez-Antolin, R:
Univ Hosp San Carlos, Intervent Cardiol Unit, Madrid, Spain
Mainar, V:
Hosp Gen Alicante, Intervent Cardiol Unit, Alicante, Spain
Valgimigli, M:
Univ Hosp Ferrara, Intervent Cardiol Unit, Ferrara, Italy
Tespili, M:
Univ Hosp Bolognini Seriate, Intervent Cardiol Unit, Bergamo, Italy
den Heijer, P:
Amphia Ziekenhuis, Intervent Cardiol Unit, Breda, Netherlands
Bethencourt, A:
Hosp Son Espases, Intervent Cardiol Unit, Palma de Mallorca, Spain
Vazquez, N:
Hosp Juan Canalejo, Intervent Cardiol Unit, A Crouna, Spain
Backx, B:
Erasmus MC, Intervent Cardiol Unit, Rotterdam, Netherlands
Serruys, PW:
Cardialysis, Rotterdam, Netherlands
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