Document Detail


Impact of advanced age on the safety and effectiveness of paclitaxel-eluting stent implantation in patients with ST-segment elevation myocardial infarction undergoing primary angioplasty: The HORIZONS-AMI trial.
MedLine Citation:
PMID:  23359554     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objectives: To assess the impact of age on safety and efficacy of paclitaxel-eluting stent (PES) implantation during primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Background: The benefits of paclitaxel-eluting stent (PES) implantation during primary PCI were confirmed by the long-term results of the HORIZONS-AMI trial. Whether the effects of PES are independent of age has not been reported. Methods: Data on 3006 patients from the HORIZONS-AMI study randomized in a 3:1 ratio to PES or bare-metal stent (BMS) in whom at least one stent was implanted were assessed. There were 2302 (76.6%) patients <70, and 704 patients (70 years of age. Results: At 3 years, among older patients a trend toward lower risk of major adverse cardiac events (MACE; death from any cause, stroke, reinfarction and unplanned revascularization for ischemia) related to PES use was observed (PES vs BMS: 18.0% vs 21.3%; P=0.07). There was also a trend for reduction of MACE related to PES in older patients (26.4% vs 33.1%; P=0.09). Both, patients <70 and (70 years of age treated with PES were at lower risk for ischemic target vessel revascularization. However, a higher risk of major bleeding in elderly patients treated with PES was observed (P=0.02 for interaction between age group and PES effects). No interaction between age and stent type in terms of the risk of other clinical end points, including all-cause death, was confirmed. Conclusions: For STEMI patients undergoing primary PCI, the implantation of PES as compared with BMS reduced ischemic TVR, and this effect was independent of age. [NCT00433966] © 2013 Wiley-Liss, Inc.
Authors:
Dariusz Dudek; Roxana Mehran; Artur Dziewierz; Bernhard Witzenbichler; Bruce R Brodie; Ran Kornowski; Martin Fahy; Alexandra J Lansky; Tomasz Rakowski; Jacek Legutko; Leszek Bryniarski; Gregg W Stone
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-29
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Wiley Periodicals, Inc.
Affiliation:
Department of Interventional Cardiology, Jagiellonian University Medical College, Krakow, Poland. mcdudek@cyfronet.pl.
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