Efficacy and Safety of Stents in ST-Segment Elevation Myocardial Infarction

被引：39

作者：

Chichareon, Ply ^{[1
,2
]}

Modolo, Rodrigo ^{[1
,3
]}

Collet, Carlos ^{[1
,4
]}

Tenekecioglu, Erhan ^{[5
]}

Vink, Maarten A. ^{[6
]}

Oh, Pyung Chun ^{[7
]}

Ahn, Jung-Min ^{[8
]}

Musto, Carmine ^{[9
]}

de la Llera, Luis S. Diaz ^{[10
]}

Cho, Young-Seok ^{[11
]}

Violini, Roberto ^{[9
]}

Park, Seung-Jung ^{[8
]}

Suryapranata, Harry ^{[12
]}

Piek, Jan J. ^{[1
]}

de Winter, Robbert J. ^{[1
]}

Wykrzykowska, Joanna J. ^{[1
]}

Spaulding, Christian ^{[13
]}

Kang, Woong Chol ^{[7
]}

Slagboom, Ton ^{[6
]}

Hofma, Sjoerd H. ^{[14
]}

Wijnbergen, Inge F. ^{[15
]}

Di Lorenzo, Emilio ^{[16
]}

Pijls, Nico H. ^{[15
]}

Raber, Lorenz ^{[17
]}

Brugaletta, Salvatore ^{[18
]}

Sabate, Manel ^{[18
]}

Stoll, Hans-Peter ^{[19
]}

Stone, Gregg W. ^{[20
,21
]}

Windecker, Stephan ^{[17
]}

Onuma, Yoshinobu ^{[4
,22
]}

Serruys, Patrick W. ^{[23
]}

机构：

[1] Univ Amsterdam, Dept Clin & Expt Cardiol, Heart Ctr, Amsterdam Cardiovasc Sci,Amsterdam UMC, Amsterdam, Netherlands

[2] Prince Songkla Univ, Dept Internal Med, Cardiol Unit, Fac Med, Hat Yai, Thailand

[3] Univ Campinas UNICAMP, Div Cardiol, Dept Internal Med, Campinas, SP, Brazil

[4] OLV Clin, Cardiovasc Ctr Aalst, Aalst, Belgium

[5] Erasmus MC, Rotterdam, Netherlands

[6] OLVG Hosp, Amsterdam, Netherlands

[7] Gachon Univ, Dept Cardiol, Gil Med Ctr, Incheon, South Korea

[8] Univ Ulsan, Asan Med Ctr, Dept Cardiol, Coll Med, Seoul, South Korea

[9] San Camillo Hosp, Intervent Cardiol Unit, Rome, Italy

[10] Hosp Univ Virgen del Rocio, Unidad Hemodinam & Cardiol Intervencionista, Seville, Spain

[11] Seoul Natl Univ, Bundang Hosp, Seongnam, South Korea

[12] Radboud Univ Nijmegen, Dept Cardiol, Med Ctr, Nijmegen, Netherlands

[13] Paris Descartes Univ, European Hosp Georges Pompidou, AP HP, Sudden Death Expert Ctr,INSERM,U970,PARCC,Cardiol, Paris, France

[14] Med Ctr Leeuwarden, Leeuwarden, Netherlands

[15] Catharina Hosp, Dept Cardiol, Eindhoven, Netherlands

[16] G Moscati Hosp, Cardiol Dept, Avellino, Italy

[17] Univ Bern, Bern Univ Hosp, Dept Cardiol, Inselspital, Bern, Switzerland

[18] Univ Barcelona, Inst Clin Cardiovasc, Inst Invest Biomed August Pi & Sunyer IDIBAPS, Hosp Clin, Barcelona, Spain

[19] Biosensors Clin Res, Morges, Switzerland

[20] Columbia Univ, New York Presbyterian Hosp, Med Ctr, New York, NY USA

[21] Cardiovasc Res Fdn, New York, NY USA

[22] Cardialysis Clin Trials Management & Core Labs, Rotterdam, Netherlands

[23] Imperial Coll London, Dept Cardiol, London, England

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2019年 / 74卷 / 21期

关键词：

bare-metal stents; drug-eluting stents; efficacy; individual patient data network meta-analysis; safety; ST-segment elevation myocardial infarction; PERCUTANEOUS CORONARY INTERVENTION; BARE-METAL STENTS; DRUG-ELUTING STENTS; FINAL 5-YEAR REPORT; BIODEGRADABLE POLYMER; NETWORK METAANALYSIS; CLINICAL-OUTCOMES; COMPARE II; THROMBOSIS; GUIDELINES;

D O I：

10.1016/j.jacc.2019.09.038

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND To date, no specific drug-eluting stent (DES) has fully proven its superiority over others in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention. OBJECTIVES The purpose of this study was to compare the safety and efficacy of coronary artery stents in STEMI patients in a patient-level network meta-analysis. METHODS Eligible studies were dedicated randomized controlled trials comparing different stents in STEMI patients undergoing percutaneous coronary intervention with at least 12 months of clinical follow-up. Of 19 studies identified from the published data, individual patient data were collected in 15 studies with 10,979 patients representing 87.7% of patients in the overall network of evidence. The primary endpoint was the composite of cardiac death, reinfarction, or target lesion revascularization. RESULTS Overall, 8,487 (77.3%) of 10,979 STEMI patients were mate and the mean age was 60.7 years. At a median follow-up of 3 years, compared with bare-metal stents (BMS), patients treated with paclitaxel-, sirolimus-, everolimus-, or biolimus-eluting stents had a significantly lower risk of the primary endpoint (adjusted hazard ratios [HRs]: 0.74 [95% confidence interval (0): 0.63 to 0.88], 0.65 [95% 0: 0.49 to 0.85], 0.70 [95% CI: 0.53 to 0.91], and 0.66 [95% CI: 0.49 to 0.88], respectively). The risk of primary endpoint was not different between patients treated with BMS and zotarolimus-eluting stents (adjusted HR: 0.83 [95% 0: 0.51 to 1.38]). Among patients treated with DES, no significant difference in the risk of the primary outcome was demonstrated. Treatment with second-generation DES was associated with significantly tower risk of definite or probable stent thrombosis compared with BMS (adjusted HR: 0.61 [95% 0: 0.42 to 0.89]) and first-generation DES (adjusted HR: 0.56 [95% CI: 0.36 to 0.88]). CONCLUSIONS In STEMI patients, DES were superior to BMS with respect to tong-term efficacy. No difference in long-term efficacy and safety was observed among specific DES. Second-generation were superior to first-generation DES in reducing stent thrombosis. (C) 2019 by the American College of Cardiology Foundation.

引用

页码：2572 / 2584

页数：13

共 29 条

[1]

[Anonymous], 2013, BMJ BRIT MED J, DOI DOI 10.1136/BMJ.F6625

[2] Very Late Stent Thrombosis After Primary Percutaneous Coronary Intervention With Bare-Metal and Drug-Eluting Stents for ST-Segment Elevation Myocardial Infarction A 15-Year Single-Center Experience [J].

Brodie, Bruce ;

Pokharel, Yashashwi ;

Fleishman, Nathan ;

Bensimhon, Adam ;

Kissling, Grace ;

Hansen, Charles ;

Milks, Sally ;

Cooper, Michael ;

McAlhany, Christopher ;

Stuckey, Tom .

JACC-CARDIOVASCULAR INTERVENTIONS, 2011, 4 (01) :30-38

[3] Biolimus-eluting biodegradable polymer-coated stent versus durable polymer-coated sirolimus-eluting stent in unselected patients receiving percutaneous coronary intervention (SORT OUT V): a randomised non-inferiority trial [J].

Christiansen, Evald Hoj ;

Jensen, Lisette Okkels ;

Thayssen, Per ;

Tilsted, Hans-Henrik ;

Krusell, Lars Romer ;

Hansen, Knud Norregaard ;

Kaltoft, Anne ;

Maeng, Michael ;

Kristensen, Steen Dalby ;

Botker, Hans Erik ;

Terkelsen, Christian Juhl ;

Villadsen, Anton Boel ;

Ravkilde, Jan ;

Aaroe, Jens ;

Madsen, Morten ;

Thuesen, Leif ;

Lassen, Jens Flensted .

LANCET, 2013, 381 (9867) :661-669

[4]

De Luca G, 2012, ARCH INTERN MED, V172, P611, DOI 10.1001/archinternmed.2012.758

[5] Incomplete Stent Apposition and Delayed Tissue Coverage Are More Frequent in Drug-Eluting Stents Implanted During Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction Than in Drug-Eluting Stents Implanted for Stable/Unstable Angina Insights From Optical Coherence Tomography [J].

Gonzalo, Nieves ;

Barlis, Peter ;

Serruys, Patrick W. ;

Garcia-Garcia, Hector M. ;

Onuma, Yoshinobu ;

Ligthart, Jurgen ;

Regar, Evelyn .

JACC-CARDIOVASCULAR INTERVENTIONS, 2009, 2 (05) :445-452

[6] The Cochrane Collaboration's tool for assessing risk of bias in randomised trials [J].

Higgins, Julian P. T. ;

Altman, Douglas G. ;

Gotzsche, Peter C. ;

Jueni, Peter ;

Moher, David ;

Oxman, Andrew D. ;

Savovic, Jelena ;

Schulz, Kenneth F. ;

Weeks, Laura ;

Sterne, Jonathan A. C. .

BMJ-BRITISH MEDICAL JOURNAL, 2011, 343

[7] The PRISMA Extension Statement for Reporting of Systematic Reviews Incorporating Network Meta-analyses of Health Care Interventions: Checklist and Explanations [J].

Hutton, Brian ;

Salanti, Georgia ;

Caldwell, Deborah M. ;

Chaimani, Anna ;

Schmid, Christopher H. ;

Cameron, Chris ;

Ioannidis, John P. A. ;

Straus, Sharon ;

Thorlund, Kristian ;

Jansen, Jeroen P. ;

Mulrow, Cynthia ;

Catala-Lopez, Ferran ;

Gotzsche, Peter C. ;

Dickersin, Kay ;

Boutron, Isabelle ;

Altman, Douglas G. ;

Moher, David .

ANNALS OF INTERNAL MEDICINE, 2015, 162 (11) :777-784

[8] 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC) [J].

Ibanez, Borja ;

James, Stefan ;

Agewall, Stefan ;

Antunes, Manuel J. ;

Bucciarelli-Ducci, Chiara ;

Bueno, Hector ;

Caforio, Alida L. P. ;

Crea, Filippo ;

Goudevenos, John A. ;

Halvorsen, Sigrun ;

Hindricks, Gerhard ;

Kastrati, Adnan ;

Lenzen, Mattie J. ;

Prescott, Eva ;

Roffi, Marco ;

Valgimigli, Marco ;

Varenhorst, Christoph ;

Vranckx, Pascal ;

Widimsky, Petr ;

Collet, Jean-Philippe ;

Kristensen, Steen Dalby ;

Aboyans, Victor ;

Baumbach, Andreas ;

Bugiardini, Raffaele ;

Coman, Ioan Mircea ;

Delgado, Victoria ;

Fitzsimons, Donna ;

Gaemperli, Oliver ;

Gershlick, Anthony H. ;

Gielen, Stephan ;

Harjola, Veli-Pekka ;

Katus, Hugo A. ;

Knuuti, Juhani ;

Kolh, Philippe ;

Leclercq, Christophe ;

Lip, Gregory Y. H. ;

Morais, Joao ;

Neskovic, Aleksandar N. ;

Neumann, Franz-Josef ;

Niessner, Alexander ;

Piepoli, Massimo Francesco ;

Richter, Dimitrios J. ;

Shlyakhto, Evgeny ;

Simpson, Iain A. ;

Steg, Ph. Gabriel ;

Terkelsen, Christian Juhl ;

Thygesen, Kristian ;

Windecker, Stephan ;

Zamorano, Jose Luis ;

Zeymer, Uwe .

EUROPEAN HEART JOURNAL, 2018, 39 (02) :119-177

[9] Ten-Year Clinical Outcomes From a Trial of Three Limus-Eluting Stents With Different Polymer Coatings in Patients With Coronary Artery Disease: Results From the ISAR-TEST 4 Randomized Trial [J].

Kufner, Sebastian ;

Joner, Michael ;

Thannheimer, Anna ;

Hoppmann, Petra ;

Ibrahim, Tareq ;

Mayer, Katharina ;

Cassese, Salvatore ;

Laugwitz, Karl-Ludwig ;

Schunkert, Heribert ;

Kastrati, Adnan ;

Byrne, Robert A. .

CIRCULATION, 2019, 139 (03) :325-333

[10] Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction Long-Term Outcome After Bare Metal and Drug-Eluting Stent Implantation [J].

Kukreja, Neville ;

Onuma, Yoshinobu ;

Garcia-Garcia, Hector ;

Daemen, Joost ;

van Domburg, Ron ;

Serruys, Patrick W. .

CIRCULATION-CARDIOVASCULAR INTERVENTIONS, 2008, 1 (02) :103-110

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