Clinical outcomes after treating acute coronary syndrome patients with a drug-eluting stent: results from REWARDS-EMI (Endeavor for Myocardial Infarction Registry).

MedStar author(s):
Citation: Cardiovascular Revascularization Medicine. 14(3):128-33, 2013 May-Jun.PMID: 23642502Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Comparative Study | Journal Article | Observational StudySubject headings: *Acute Coronary Syndrome/th [Therapy] | *Cardiovascular Agents/ad [Administration & Dosage] | *Drug-Eluting Stents | *Myocardial Infarction/th [Therapy] | *Paclitaxel/ad [Administration & Dosage] | *Percutaneous Coronary Intervention/is [Instrumentation] | *Sirolimus/aa [Analogs & Derivatives] | Acute Coronary Syndrome/di [Diagnosis] | Acute Coronary Syndrome/mo [Mortality] | Aged | Coronary Angiography | Disease-Free Survival | District of Columbia | Female | Humans | Kaplan-Meier Estimate | Male | Middle Aged | Multivariate Analysis | Myocardial Infarction/di [Diagnosis] | Myocardial Infarction/mo [Mortality] | Percutaneous Coronary Intervention/ae [Adverse Effects] | Percutaneous Coronary Intervention/mo [Mortality] | Prospective Studies | Prosthesis Design | Registries | Risk Factors | Sirolimus/ad [Administration & Dosage] | Time Factors | Treatment OutcomeLocal holdings: Available in print through MWHC library: 2002 - presentISSN:
  • 1878-0938
Name of journal: Cardiovascular revascularization medicine : including molecular interventionsAbstract: BACKGROUND: Drug-eluting stents have shown promising clinical results in the treatment of acute coronary syndrome (ACS) patients. We aimed to evaluate the long-term outcome of Endeavor zotarolimus-eluting stent (EZES) implantation in an ACS population and to compare these results with those obtained in patients treated with sirolimus-eluting (SES) and paclitaxel-eluting stents (PES).CONCLUSION: In an ACS patient population, a lower long-term MACE rate was observed in patients treated with an EZES when compared to treatment with first-generation drug-eluting stents. The use of EZES in contemporary practice has excellent long-term outcome in terms of low rates of revascularization and clinical events. Copyright 2013. Published by Elsevier Inc.METHODS: This prospective study included 1481 consecutive ACS patients (72% myocardial infarction, age 65 + 13 years, 62% male) treated with a drug-eluting stent: (SES, n=925; PES, n=417; EZES, n=139). The primary end point was major adverse cardiac events (MACE) at 2 years, defined as the composite of death, myocardial infarction, and target vessel revascularization. Two-year follow-up was obtained in all patients.RESULTS: Baseline clinical and angiographic characteristics were mostly similar. Unadjusted 2-year MACE and death rates were lower in the EZES group than in the SES and PES groups (MACE: 18.7% vs. 25.3% vs. 30.2%, p=0.02; death: 10.1% vs. 16.4% vs. 22.2%, p=0.002, respectively). The rate of definite stent thrombosis at 2 years was lower in the EZES group without statistically significant difference (0.7% vs. 2.9% SES vs. 1.7% PES, p=0.16). After adjusting for differences in baseline characteristics, EZES use was an independent correlate for 2-year MACE (vs. SES, hazard ratio 0.65, p=0.049; vs. PES, hazard ratio 0.57, p=0.01).All authors: Badr S, Barbash IM, Ben-Dor I, Dvir D, Laynez-Carnicero A, Pichard AD, Sardi GL, Satler LF, Torguson R, Waksman RDigital Object Identifier: Date added to catalog: 2014-04-03
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article Available 23642502

Available in print through MWHC library: 2002 - present

BACKGROUND: Drug-eluting stents have shown promising clinical results in the treatment of acute coronary syndrome (ACS) patients. We aimed to evaluate the long-term outcome of Endeavor zotarolimus-eluting stent (EZES) implantation in an ACS population and to compare these results with those obtained in patients treated with sirolimus-eluting (SES) and paclitaxel-eluting stents (PES).

CONCLUSION: In an ACS patient population, a lower long-term MACE rate was observed in patients treated with an EZES when compared to treatment with first-generation drug-eluting stents. The use of EZES in contemporary practice has excellent long-term outcome in terms of low rates of revascularization and clinical events. Copyright 2013. Published by Elsevier Inc.

METHODS: This prospective study included 1481 consecutive ACS patients (72% myocardial infarction, age 65 + 13 years, 62% male) treated with a drug-eluting stent: (SES, n=925; PES, n=417; EZES, n=139). The primary end point was major adverse cardiac events (MACE) at 2 years, defined as the composite of death, myocardial infarction, and target vessel revascularization. Two-year follow-up was obtained in all patients.

RESULTS: Baseline clinical and angiographic characteristics were mostly similar. Unadjusted 2-year MACE and death rates were lower in the EZES group than in the SES and PES groups (MACE: 18.7% vs. 25.3% vs. 30.2%, p=0.02; death: 10.1% vs. 16.4% vs. 22.2%, p=0.002, respectively). The rate of definite stent thrombosis at 2 years was lower in the EZES group without statistically significant difference (0.7% vs. 2.9% SES vs. 1.7% PES, p=0.16). After adjusting for differences in baseline characteristics, EZES use was an independent correlate for 2-year MACE (vs. SES, hazard ratio 0.65, p=0.049; vs. PES, hazard ratio 0.57, p=0.01).

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