Benefits of drug-eluting stents as compared to bare metal stent in ST-segment elevation myocardial infarction: Four year results of the PaclitAxel or Sirolimus-Eluting stent vs bare metal stent in primary angiOplasty (PASEO) randomized trial

Lorenzo, Emilio Di; Sauro, Rosario; Varricchio, Attilio; Capasso, Michele; Lanzillo, Tonino; Manganelli, Fiore; Mariello, Ciro; Siano, Francesco; Pagliuca, Maria Rosaria; Stanco, Giovanni; Rosato, Giuseppe; Luca, Giuseppe De

doi:10.1016/j.ahj.2009.03.016

Cited by 84 publications

(51 citation statements)

References 30 publications

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“…Details on study design have already been reported [24,25]. Briefly, individuals eligible for enrolment were consecutive patients presenting with STEMI who fulfilled all the following inclusion criteria: (1) chest pain for more than 30 min; (2) ST-segment elevation of 1 mm or more in 2 or more contiguous electrocardiograph leads or with presumably new left bundle-branch block; (3) Hospital admission within 12 h from symptoms onset.…”

Section: Methodsmentioning

confidence: 99%

“…However, concerns have emerged on the potential higher risk of stent thrombosis and death with DES [19][20][21][22], that might be even more pronounced among STEMI patients, as suggested by a prospective registry [23]. In the PaclitAxel or SirolimusEluting Stent vs Bare Metal Stent in primary angioplasty (PASEO) randomized trial 270 STEMI patients were randomized to SES, PES or BMS (1:1:1) [24,25]. The aim of the current study was to evaluate the impact of diabetes on 5-year outcome in patients undergoing primary angioplasty with Glycoprotein IIb-IIIa inhibitors with or without DES.…”

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confidence: 99%

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Impact of diabetes on long-term outcome in STEMI patients undergoing primary angioplasty with glycoprotein IIb–IIIa inhibitors and BMS or DES

Luca

Sauro

Varricchio

et al. 2009

J Thromb Thrombolysis

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Diabetes has been shown to be associated with worse survival and repeat revascularization (TVR) after primary angioplasty. Drug-eluting stent (DES) may offer benefits in terms of TVR, that may be counterbalanced by an higher risk of stent thrombosis, especially among STEMI patients. Aim of the current study was to evaluate the impact of diabetes on 5-year outcome in patients undergoing primary angioplasty with glycoprotein IIb-IIIa inhibitors in the era of DES. Our population is represented by STEMI patients undergoing primary angioplasty and stent implantation at a tertiary center with 24-h primary PCI capability within 12 h of symptom onset. All patients received glycoprotein IIb-IIIa inhibitors. No patient was lost to follow up. From 2003 to 2005, 270 STEMI patients were treated with DES (n = 180), or BMS (n = 90). A total of 69 patients had history of diabetes at admission (25.5%). At a follow-up of 1510 +/- 406 days, diabetes was associated with a higher rate of death (29.5 vs. 5.1%, P < 0.0001), reinfarction (24.1 vs. 9.1%, P < 0.0001), TVR (19.1 vs. 13.1%, P = 0.052), IST (17.2 vs. 6.8%, P < 0.001) and MACE (51.9 vs. 25.1%, P < 0.001). These results were confirmed in both patients receiving BMS or DES, except for TVR, where no difference was observed between diabetic and non-diabetic patients. This study shows that among STEMI patients undergoing primary angioplasty with Gp IIb-IIIa inhibitors, diabetes is associated with worse long-term mortality, reinfarction, and IST, even with DES implantation, that, however, were able to equalize the outcome in terms of TVR as compared to non diabetic patients.

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

Impact of diabetes on long-term outcome in STEMI patients undergoing primary angioplasty with glycoprotein IIb–IIIa inhibitors and BMS or DES

Luca

Sauro

Varricchio

et al. 2009

J Thromb Thrombolysis

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“…Availability of pharmacologic and mechanical reperfusion therapies has significantly reduced cardiac mortality among ST-segment elevation acute myocardial infarction (STEMI) patients [1][2][3][4][5][6][7][8][9][10][11]. However, even though primary angioplasty has been shown to be superior to thrombolysis, mainly due to a larger success in epicardial recanalization, a suboptimal myocardial reperfusion is observed in a still relevant percentage of patients [12,13].…”

Section: Introductionmentioning

confidence: 99%

Time-to-treatment and infarct size in STEMI patients undergoing primary angioplasty

Luca¹,

Parodi

Sciagrà

et al. 2013

International Journal of Cardiology

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Background: Several reports have shown that in patient with ST-segment elevation acute myocardial infarction (STEMI) longer ischemia time is associated with impaired reperfusion and higher mortality. However, there is still some doubts with regards time to reperfusion role in patients treated with primary percutaneous coronary intervention (PCI). Therefore, the aim of the current study was to evaluate the impact of time-totreatment on infarct size as evaluated by myocardial scintigraphy in a large cohort of STEMI patients undergoing primary PCI. Methods: Our population is represented by 830 STEMI patients undergoing primary PCI. Infarct size was evaluated at 30 days by technetium-99m-sestamibi. Conclusions: This study shows in a large population of STEMI patients undergoing primary PCI that time-totreatment is linearly associated with infarct size.

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“…In the PASEO trial we evaluated benefits and safety of both PES and SES versus BMS in patients undergoing primary angioplasty for STEMI at a long-term follow-up [36,37]. The main finding of our study is that PES and SES are more effective than BMS mainly because of a reduction in TLR, with no excess risk of thrombotic complications.…”

Section: Des In Primary Angioplastymentioning

confidence: 79%

Bare-Metal Stents Versus Drug-Eluting Stents for Primary Angioplasty: Long-Term Outcome

Lorenzo

Carbone

et al. 2011

Curr Cardiol Rep

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Percutaneous transluminal coronary intervention (PCI) is the most used myocardial revascularization technique for patients with coronary artery disease. Primary PCI with stent implantation is widely considered the gold standard for the treatment of ST-elevation myocardial infarction patients. Coronary stents, compared with balloon angioplasty, have reduced focal lesion restenosis. To reduce in-stent restenosis, drug-eluting stents (DES) were designed to locally release drugs inhibiting neointimal growth. Recent concerns have emerged on the potential higher risk of stent thrombosis with DES that might be even more pronounced among myocardial infarction patients. For these reasons, DES for primary PCI remains an "off-label" use. In the last several years, a number of randomized trials and registries have tested the safety and efficacy of DES in primary PCI. Data from these studies were analyzed in several meta-analyses, reasonably consistently demonstrating that the use of DES significantly decreased the need for revascularization without an increase in the incidence of death, recurrent infarction, or stent thrombosis at long-term follow-up.

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Benefits of drug-eluting stents as compared to bare metal stent in ST-segment elevation myocardial infarction: Four year results of the PaclitAxel or Sirolimus-Eluting stent vs bare metal stent in primary angiOplasty (PASEO) randomized trial

Cited by 84 publications

References 30 publications

Impact of diabetes on long-term outcome in STEMI patients undergoing primary angioplasty with glycoprotein IIb–IIIa inhibitors and BMS or DES

Impact of diabetes on long-term outcome in STEMI patients undergoing primary angioplasty with glycoprotein IIb–IIIa inhibitors and BMS or DES

Time-to-treatment and infarct size in STEMI patients undergoing primary angioplasty

Bare-Metal Stents Versus Drug-Eluting Stents for Primary Angioplasty: Long-Term Outcome

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