Document Detail


5-year follow-up after primary percutaneous coronary intervention with a paclitaxel-eluting stent versus a bare-metal stent in acute ST-segment elevation myocardial infarction: a follow-up study of the PASSION (Paclitaxel-Eluting Versus Conventional Stent in Myocardial Infarction with ST-Segment Elevation) trial.
MedLine Citation:
PMID:  21251625     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to evaluate the long-term outcomes of the PASSION (Paclitaxel-Eluting Versus Conventional Stent in Myocardial Infarction with ST-Segment Elevation) trial.
BACKGROUND: In primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction (STEMI), the use of drug-eluting stents (DES) is still controversial. Several randomized controlled trials of DES, compared with bare-metal stents (BMS), with short-term follow-up showed a reduction in target lesion revascularization (TLR), but no differences in rates of cardiac death or recurrent myocardial infarction. Moreover, the occurrence of (very) late stent thrombosis (ST) continues to be of major concern, and, therefore, long-term follow-up results are needed.
METHODS: We randomly assigned 619 patients presenting with STEMI to a paclitaxel-eluting stent (PES) or the similar BMS. The primary end point was the composite of cardiac death, recurrent myocardial infarction, or TLR. We performed clinical follow-up at 5 years.
RESULTS: At 5 years, the occurrence of the composite of cardiac death, recurrent myocardial infarction, or TLR was comparable at 18.6% versus 21.8% in PES and BMS, respectively (hazard ratio [HR]: 0.82, 95% confidence interval [CI]: 0.58 to 1.18, p = 0.28). The incidence of definite or probable ST was 12 (4.2%) in the PES group and 10 (3.4%) in the BMS group (HR: 1.19, 95% CI: 0.51 to 276, p = 0.68).
CONCLUSIONS: In the present analysis of PES compared with BMS in primary percutaneous coronary intervention for STEMI, no significant difference in major adverse cardiac events was observed. In addition, no difference in the incidence of definite or probable ST was seen, although very late ST was almost exclusively seen after the use of PES. (Paclitaxel-Eluting Versus Conventional Stent in Myocardial Infarction with ST-Segment Elevation [PASSION]; ISRCTN65027270).
Authors:
Maarten A Vink; Maurits T Dirksen; Maarten J Suttorp; Jan G P Tijssen; Jeroen van Etten; Mark S Patterson; Ton Slagboom; Ferdinand Kiemeneij; Gerrit J Laarman
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JACC. Cardiovascular interventions     Volume:  4     ISSN:  1876-7605     ISO Abbreviation:  JACC Cardiovasc Interv     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-21     Completed Date:  2011-05-03     Revised Date:  2012-08-29    
Medline Journal Info:
Nlm Unique ID:  101467004     Medline TA:  JACC Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  24-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands. m.a.vink@olvg.nl
Data Bank Information
Bank Name/Acc. No.:
ISRCTN/ISRCTN65027270
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon, Coronary / adverse effects,  instrumentation*,  mortality
Cardiovascular Agents / administration & dosage*
Drug-Eluting Stents*
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Metals*
Myocardial Infarction / mortality,  therapy*
Netherlands
Paclitaxel / administration & dosage*
Proportional Hazards Models
Prospective Studies
Recurrence
Risk Assessment
Risk Factors
Single-Blind Method
Stents*
Thrombosis / etiology
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Cardiovascular Agents; 0/Metals; 33069-62-4/Paclitaxel
Comments/Corrections
Comment In:
JACC Cardiovasc Interv. 2011 Jan;4(1):39-41   [PMID:  21251627 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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