Four-Year Follow-Up of TYPHOON (Trial to Assess the Use of the CYPHer Sirolimus-Eluting Coronary Stent in Acute Myocardial Infarction Treated With BallOON Angioplasty)

被引：91

作者：

Spaulding, Christian ^{[1
,2
]}

Teiger, Emmanuel ^{[3
]}

Commeau, Philippe ^{[4
]}

Varenne, Olivier ^{[2
]}

Bramucci, Ezio ^{[5
]}

Slama, Michel ^{[6
]}

Beatt, Keavin ^{[7
]}

Tirouvanziam, Ashok ^{[8
]}

Polonski, Lech ^{[9
]}

Stella, Pieter R. ^{[10
]}

Clugston, Richard ^{[11
]}

Fajadet, Jean ^{[12
]}

de Boisgelin, Xavier ^{[13
]}

Bode, Christophe ^{[14
]}

Carrie, Didier ^{[15
]}

Erglis, Andrejs ^{[16
]}

Merkely, Bela ^{[17
]}

Hosten, Stefan ^{[18
]}

Cebrian, Ana ^{[18
]}

Wang, Patrick ^{[18
]}

Stoll, Hans-Peter ^{[18
]}

Henry, Patrick ^{[19
]}

机构：

[1] Paris Descartes Univ, Dept Cardiol, Cochin Hosp, Assistance Publ Hop Paris, F-75014 Paris, France

[2] INSERM, U970, Paris, France

[3] Henri Mondor Hosp, Assistance Publ Hop Paris, Paris, France

[4] Polyclin Fleurs, Ollioules, France

[5] Policlin S Matteo Pavia, Pavia, Italy

[6] Hop Antoine Beclere, Clamart, France

[7] Mayday Univ Hosp, London, England

[8] CHU Nantes, Hop Guillaume & Rene Laennec, F-44035 Nantes 01, France

[9] Slaskie Ctr Chorob Serca, Zabrze, Poland

[10] Heart Lung Ctr, Univ Med Ctr, Utrecht, Netherlands

[11] Royal Perth Hosp, Perth, WA, Australia

[12] Clin Pasteur, Toulouse, France

[13] Clin Millenaire, Montpellier, France

[14] Univ Freiburg Klinikum, Freiburg, Germany

[15] Hop Rangueil, Toulouse, France

[16] Pauls Stradins Univ Hosp, Riga, Latvia

[17] Semmelweis Univ, Budapest, Hungary

[18] Cordis Corp Johnson & Johnson, Waterloo, Belgium

[19] Hop Lariboisiere, F-75475 Paris, France

来源：

JACC-CARDIOVASCULAR INTERVENTIONS | 2011年 / 4卷 / 01期

关键词：

bare-metal stent; percutaneous coronary intervention; sirolimus-eluting coronary stent; target lesion revascularization; BARE-METAL STENTS; UNCOATED STENTS; CLINICAL-PRACTICE; THROMBOSIS; CLOPIDOGREL; IMPLANTATION; PLACEMENT; OUTCOMES; THERAPY; DISCONTINUATION;

D O I：

10.1016/j.jcin.2010.10.007

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives The aim of this study was to assess the long-term safety and efficacy of the CYPHER (Cordis, Johnson and Johnson, Bridgewater, New Jersey) sirolimus-eluting coronary stent (SES) in percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). Background Concern over the safety of drug-eluting stents implanted during PCI for STEMI remains, and long-term follow-up from randomized trials are necessary. TYPHOON (Trial to assess the use of the cYPHer sirolimus-eluting stent in acute myocardial infarction treated with ballOON angioplasty) randomized 712 patients with STEMI treated by primary PCI to receive either SES (n = 355) or bare-metal stents (BMS) (n = 357). The primary end point, target vessel failure at 1 year, was significantly lower in the SES group than in the BMS group (7.3% vs. 14.3%, p = 0.004) with no increase in adverse events. Methods A 4-year follow-up was performed. Complete data were available in 501 patients (70%), and the survival status is known in 580 patients (81%). Results Freedom from target lesion revascularization (TLR) at 4 years was significantly better in the SES group (92.4% vs. 85.1%; p = 0.002); there were no significant differences in freedom from cardiac death (97.6% and 95.9%; p = 0.37) or freedom from repeat myocardial infarction (94.8% and 95.6%; p = 0.85) between the SES and BMS groups. No difference in definite/probable stent thrombosis was noted at 4 years (SES: 4.4%, BMS: 4.8%, p = 0.83). In the 580 patients with known survival status at 4 years, the all-cause death rate was 5.8% in the SES and 7.0% in the BMS group (p = 0.61). Conclusions In the 70% of patients with complete follow-up at 4 years, SES demonstrated sustained efficacy to reduce TLR with no difference in death, repeat myocardial infarction or stent thrombosis. (The Study to Assess AMI Treated With Balloon Angioplasty [TYPHOON]; NCT00232830) (J Am Coll Cardiol Intv 2011;4: 14-23) (C) 2011 by the American College of Cardiology Foundation

引用

页码：14 / 23

页数：10

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