Efficacy and safety of drug-eluting stents in ST-segment elevation myocardial infarction: A meta-analysis of randomized trials

Luca, Giuseppe De; Stone, Gregg W.; Suryapranata, Harry; Laarman, Gerrit J.; Menichelli, Maurizio; Kaiser, Christoph; Valgimigli, Marco; Lorenzo, Emilio Di; Dirksen, Maurits T.; Spaulding, Christian; Pittl, Undine; Violini, Roberto; Percoco, Gianfranco; Marino, Paolo

doi:10.1016/j.ijcard.2007.12.040

Cited by 89 publications

(46 citation statements)

References 51 publications

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“…Three meta-analyses of these trials have concluded that there were no differences in death, MI, or stent thrombosis rates, but TVR rates were decreased with DES. [115][116][117] Variably included were 12 studies that differed in trial design, inclusion criteria, end-point definitions, stent types, duration of clopidogrel treatment, and type of follow-up (angiographic versus clinical). They were limited by sample size and duration of follow-up and by usually requiring angiographic documentation of stent thrombosis, which may have underestimated its true incidence.…”

Section: Stent Selection For Stemimentioning

confidence: 99%

2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update)

Kushner¹,

Hand²,

Smith³

et al. 2009

Circulation

1,249

709

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Copies: This document is available on the World Wide Web sites of the American College of Cardiology (www.acc.org), the American Heart Association (my.americanheart.org), and the Society for Cardiovascular Angiography and Interventions (scai.org). A copy of the document is also available at http://www.americanheart.org/presenter.jhtml?identifierϭ3003999 by selecting either the "topic list" link or the "chronological list" link (No. KJ-0734). To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@wolterskluwer.com.Expert peer review of AHA Scientific Statements is conducted at the AHA National Center. For more on AHA statements and guidelines development, visit http://www.americanheart.org/presenter.jhtml?identifierϭ3023366.Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American Heart Association. Instructions for obtaining permission are located at http://www.americanheart.org/presenter.jhtml? identifierϭ4431. A link to the "Permission Request Form" appears on the right side of the page. STEMI and PCI Focused Updates PreambleA primary challenge in the development of clinical practice guidelines is keeping pace with the stream of new data on which recommendations are based. In an effort to respond promptly to new evidence, the American College of Cardiology Foundation/American Heart Association (ACCF/AHA) Task Force on Practice Guidelines has created a "focused update" process to revise the existing guideline recommendations that are affected by evolving data or opinion. Before the initiation of this focused approach, periodic updates and revisions of existing guidelines required up to 3 years to complete. Now, however, new evidence will be reviewed in an ongoing fashion to more efficiently respond to important science and treatment trends that could have a major impact on patient outcomes and quality of care. Evidence will be reviewed at least twice a year, and updates will be initiated on an as-needed basis as quickly as possible, while maintaining the rigorous methodology that the ACCF and AHA have developed during their 25 years of partnership.These updated guideline recommendations reflect a consensus of expert opinion after a thorough review primarily of late-breaking clinical trials identified through a broad-based vetting process as being important to the relevant patient population, as well as a review of other new data deemed to have an impact on patient care (see Section 1.1, Methodology and Evidence Review, for details). This focused update is not intended to represent an update based on a full literature review from the date of the previous guideline publication. Specific criteria/considerations for inclusion of new data include the following:• publication in a peer-reviewed journal;• large randomized, placebo-controlled trial(s);• nonrandomized data deemed important on the basis of results that affect current safety and efficacy assumptions; • strength/weakness of ...

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Section: Stent Selection For Stemimentioning

confidence: 99%

2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update)

Kushner¹,

Hand²,

Smith³

et al. 2009

Circulation

1,249

709

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“…Previous STEMI trials have reported lower rates of target lesion revascularization with DES compared with BMS. 13 In HORIZONS-AMI, randomization to PES versus BMS reduced the 12-month rate of target lesion revascularization from 7.5% to 4.5% (Pϭ0.002). 14 The reduction in percent volume obstruction as a result of less NIH with PES compared with BMS as demonstrated by IVUS in the present study underlies this clinical benefit.…”

Section: Discussionmentioning

confidence: 99%

Volumetric Intravascular Ultrasound Analysis of Paclitaxel-Eluting and Bare Metal Stents in Acute Myocardial Infarction

et al. 2009

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Background-Vascular responses to drug-eluting stents in ST-segment elevation myocardial infarction are unknown. In the prospective, multicenter Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial, patients with ST-segment elevation myocardial infarction within 12 hours of symptom onset were randomized 3:1 to TAXUS EXPRESS paclitaxel-eluting stents (PES) or EXPRESS bare metal stents (BMS). Methods and Results-A formal intravascular ultrasound substudy enrolled 464 patients with baseline and 13-month follow-up imaging at 36 centers. Overall, 446 lesions in 402 patients were suitable for standard qualitative and quantitative analyses, which were performed at an independent blinded core laboratory. The primary prespecified end point was the in-stent percent net volume obstruction at follow-up. Median stent length measured 23.4 mm (first and third quartiles, 18.5 and 31.9 mm). PES compared with BMS significantly reduced 13-month percent net volume obstruction (6.5% [first and third quartiles, 2.2% and 10.8%] versus 15.6% [first and third quartiles, 7.2% and 28.8%]; PϽ0.0001). PES compared with BMS also resulted in more late-acquired stent malapposition (29.6% versus 7.9%; Pϭ0.0005) resulting from positive vessel remodeling. Plaque and/or thrombus protrusion through stent struts was initially present in 70.4% of PES and 64.8% of BMS; all resolved during follow-up. New aneurysm formation, stent fracture, and subclinical thrombus were uncommon, although seen only in PES. Conclusions-PES compared with BMS significantly reduce neointimal hyperplasia in patients with ST-segment elevation myocardial infarction but also result in a high frequency of late-acquired stent malapposition as a result of positive vessel remodeling. Ongoing long-term follow-up is required to establish the clinical significance of these findings. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00433966.

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“…Three meta-analyses of these trials have concluded that there were no differences in death, MI, or stent thrombosis rates, but TVR rates were decreased with DES. [115][116][117] Variably included were 12 studies that differed in trial design, inclusion criteria, end-point definitions, stent types, duration of clopidogrel treatment, and type of followup (angiographic versus clinical). They were limited by sample size and duration of follow-up and by usually requiring angiographic documentation of stent thrombosis, which may have underestimated its true incidence.…”

Section: Recommendations For the Use Of Stents In Stemimentioning

confidence: 99%

2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST‐Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update)

Kushner¹,

Hand

Smith³

et al. 2009

Cathet Cardio Intervent

113

102

View full text Add to dashboard Cite

Efficacy and safety of drug-eluting stents in ST-segment elevation myocardial infarction: A meta-analysis of randomized trials

Cited by 89 publications

References 51 publications

2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update)

2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update)

Volumetric Intravascular Ultrasound Analysis of Paclitaxel-Eluting and Bare Metal Stents in Acute Myocardial Infarction

2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST‐Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update)

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