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)

Abstract

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).

Selective use of contemporary drug-eluting stents in primary angioplasty for ST-elevation myocardial infarction: pooled analysis of COMFORTABLE AMI and EXAMINATION

“…In primary percutaneous coronary intervention (PPCI) for acute ST-elevation myocardial infarction, first-generation DES have shown ambiguous results compared to BMS [16][17][18][19][20][21][22] . In the first year following implantation a reduced rate of TLR was documented; however, late stent thrombosis was seen more frequently in the following years and, overall, there was no benefit with a strategy of general use of DES 23 .…”

Comparison of Long-term Clinical and 1-Year Angiographic Outcomes after Primary Stenting (-12 hours) and Late Reperfusion (12 hours-) using Sirolimus-eluting Stents for ST-segment Elevated Myocardial Infarctions: A Propensity Score Matching Analysis

“…Therefore, in this almost unrestricted SES use cohort, the outcomes of the late reperfusion and primary stenting using SES groups could not be statistically compared with those of the very small number of STEMI patients treated with conservative therapy without emergent procedures, those treated using BMS and those treated without coronary stents, including CABG, as described in the Materials and Methods section. Second, although the number of STEMI patients treated with primary stenting using SES assigned to the control group for late reperfusion using SES was larger than previously reported numbers in the well-known randomized studies described above (12,13), the enrolled populations for late reperfusion were small. However, because more than 80% of the STEMI patients presented within 12 hours from symptom onset (Table 1), it was difficult to examine, on a large scale, patients with STEMI presenting 12 to 48 hours from symptom onset.…”

“…The present study reflects the clinical setting and included high-risk patients with complex lesions consistently related to cardiac events and binary restenosis, such as those with cardiac dysfunction, Killip 3-4 classifications, severe calcification, LAD ostium and thrombus-containing lesions. This study also included higher mean peak values of CK-MB >300 (IU/dL) in the primary stenting group and longer stents compared to those used in previous prospective randomized studies (Table 1) (12,13). In addition, a lack of use of glycoprotein IIb/IIIa inhibitors and the proportion of diabetic patients (as high as 40%) were other characteristics of the cohort, reflecting daily practice in Japan.…”

“…For this purpose, we compared the long-term clinical and angiographic outcomes after late reperfusion using SES in STEMI patients during emergent procedures with those of primary stenting patients by enrolling consecutive STEMI patients from a cohort of almost unrestricted use of SES evaluated in our previous report (2). The clinical outcomes of primary stenting using SES were evaluated by extending the clinical observational interval compared to that used in our previous reports (1)(2)(3) and comparing the outcomes with those of prospective randomized studies from Western countries (12,13).…”

Three-Year Follow-up of Sirolimus-Eluting Stents vs. Bare Metal Stents for Acute Myocardial Infarction

“…Similar benefits have been observed in randomized trials such as the PASEO, SESAMI, and TYPHOON studies. [19][20][21] In addition to the studies carried out in Western countries, Park et al showed that mid-to long-term outcomes were better in patients receiving DES for AMI in Korea. 22 In a 3-year follow up of the randomized DEDICATION trial, however, the rate of cardiac death was higher in the DES group compared to the BMS group.…”