Comparisons of detailed arterial healing response at seven months following implantation of an everolimus- or sirolimus-eluting stent in patients with ST-segment elevation myocardial infarction

Sawada, Takahiro; Shinke, Toshiro; Otake, Hiromasa; Mizoguchi, Takahiro; Iwasaki, Masanori; Emoto, Takuo; Terashita, Daisuke; Mizuguchi, Toru; Okamoto, Hiroshi; Matsuo, Yosuke; Kim, Sushi-ku; Takarada, Akira; Yokoyama, Mitsuhiro

doi:10.1016/j.ijcard.2012.10.043

Cited by 23 publications

(22 citation statements)

References 37 publications

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“…The assessment of strut coverage prior to full biodegradation of the polymer is somewhat debatable as any benefit associated with biodegradable polymers may occur weeks to months after completion of the biodegradation process. Compared to previous OCT reports, the present study observed a higher frequency of uncovered stent struts in SES-treated lesions (approximately 40-50% higher) [4][5][6] , while reference studies for BES at six months are lacking. This discrepancy raises two important issues related to OCT studies: first, the assessment of strut coverage is delicate with considerable intra-and inter-observer variability 7 .…”

Section: Article See Page 1389contrasting

confidence: 89%

Intricacies in the analysis and interpretation of optical coherence tomography findings

Räber

Zaugg²,

Windecker³

et al. 2014

EuroIntervention

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Section: Article See Page 1389contrasting

confidence: 89%

Intricacies in the analysis and interpretation of optical coherence tomography findings

Räber

Zaugg²,

Windecker³

et al. 2014

EuroIntervention

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“…Information on stent comparators, clinical setting, minimal DAPT duration and primary end points is delineated in table 1 . Most trials enrolled high-risk patients with stable coronary artery disease and acute coronary syndrome presentations, with six trials restricting their inclusion criteria to STEMI patients only 30 38 40 53 54 56 ; clopidogrel was administered across all studies; the composite end point of MACE was similar throughout the studies and included cardiac death, MI and repeat revascularisation; detailed definitions are listed in table 1 . Funnel plots did not reveal publication bias or small study effect and are included in the online supplementary material (see online supplementary figure S1A, B).…”

Section: Resultsmentioning

confidence: 99%

First-generation versus second-generation drug-eluting stents in current clinical practice: updated evidence from a comprehensive meta-analysis of randomised clinical trials comprising 31 379 patients

et al. 2014

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BackgroundFirst-generation drug-eluting stents (DES) have become the most widely used devices worldwide for management of coronary artery disease. As remote follow-up data were becoming available, concerns emerged in regard to their long-term safety. Second-generation DES were designed to overcome safety issues, but the results of randomised clinical trials remain conflicting.MethodsWe compared the safety and efficacy of first-generation versus second-generation Food and Drug Administration approved DES; the following devices were included: first-generation sirolimus-eluting stent (SES) and paclitaxel-eluting stents (PES); second-generation everolimus-eluting stent (EES), zotarolimus-eluting stent Endeavor and ZES-Resolute (ZES-R). Prespecified safety end points comprised ≤1 and >1 year: overall and cardiac mortality, myocardial infarction (MI), definite/definite or probable ST; efficacy end points were target lesion revascularisation and target vessel revascularisation. Composite end points were analysed as well.Results33 randomised controlled trials involving 31 379 patients with stable coronary artery disease or acute coronary syndrome undergoing DES implantation were retrieved. No differences in mortality among devices were found. In the overall class comparison, second-generation DES were associated with a 22% reduction of odds of MI at short-term OR 0.77 (95% CI 0.68 to 0.89) p=0.0002; EES reduced the odds of definite-probable ST compared with PES: OR 0.33 (95% CI 0.15 to 0.73) p=0.006; First-generation SES along with second-generation EES and ZES-R showed similar efficacy in decreasing the odds of repeat revascularisation.ConclusionsSecond-generation EES and ZES-R offer similar levels of efficacy compared with first-generation SES, but are more effective than PES; however, only second-generation EES significantly reduced the incidence of MI and ST, and therefore should be perceived as the safest DES to date.

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“…In total, our meta-analysis included data on 1720 patients (Table I). Of the enrolled 5 RCTs [14–18], three studies compared ZES versus the first-generation DES (two for ZES vs. SES vs. PES [14, 18]; one for ZES vs. SES [16]) and the remaining 2 targeted EES versus SES [15, 17]. Four trials focused on patients with ST-segment elevation AMI [14–16, 18], and one study included 96% subjects with ST-segment elevation AMI and 4% with non-ST-segment elevation AMI [17].…”

Section: Resultsmentioning

confidence: 99%

Systematic review/Meta-analysis Clinical outcomes of second- versus first-generation drug-eluting stents in patients with acute myocardial infarction: a meta-analysis of randomized controlled trials

Sun

Zhao

et al. 2014

aoms

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IntroductionIt remains unclear whether the clinical outcomes of patients with acute myocardial infarction (AMI) receiving second- and first-generation drug-eluting stents (DES) are identical. The study aimed to investigate the differences in clinical utility between the two generations of DES in these specific subjects by a meta-analysis.Material and methodsWe systemically searched PubMed and EMBASE databases and the Cochrane Library up until January 2013. Randomized trials, which compared clinical outcomes of second-generation DES (everolimus- (EES) or zotarolimus-eluting stents (ZES)) with first-generation DES (sirolimus- or paclitaxel-eluting stents) in patients with AMI were included.ResultsFive trials with 1720 AMI subjects were included in the meta-analysis. Pooled analysis demonstrated a trend toward lower incidence of stent thrombosis with the second-generation DES relative to the first-generation one (risk ratio (RR), 0.53; 95% confidence intervals (CI): 0.25–1.13; p = 0.10). However, the second-generation DES did not offer a significant advantage over the first-generation DES in reducing the incidence of target lesion revascularization (TLR) (RR = 1.73; 95% CI: 0.83–3.64; p = 0.15), major adverse cardiac events (MACEs) (RR = 0.97; p = 0.90), or all-cause death (RR = 1.00; p = 1.0). In addition, in elderly patients the second-generation DES seemed to reduce the occurrence of MACEs (RR = 0.65; p = 0.10) and stent thrombosis (RR = 0.40; p = 0.08), and the second-generation EES showed a potential benefit in lowering the MACE rate (RR = 0.55; p = 0.06).ConclusionsThe second-generation DES appeared to lower the risk of stent thrombosis in AMI patients. There might be a lower incidence of MACEs associated with the second-generation EES.

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Comparisons of detailed arterial healing response at seven months following implantation of an everolimus- or sirolimus-eluting stent in patients with ST-segment elevation myocardial infarction

Cited by 23 publications

References 37 publications

Intricacies in the analysis and interpretation of optical coherence tomography findings

Intricacies in the analysis and interpretation of optical coherence tomography findings

First-generation versus second-generation drug-eluting stents in current clinical practice: updated evidence from a comprehensive meta-analysis of randomised clinical trials comprising 31 379 patients

Systematic review/Meta-analysis Clinical outcomes of second- versus first-generation drug-eluting stents in patients with acute myocardial infarction: a meta-analysis of randomized controlled trials

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