Document Detail


In-hospital complications and long-term outcomes of the paclitaxel drug-eluting stent in acute ST-elevation myocardial infarction: a real-world experience from a high-volume medical center.
MedLine Citation:
PMID:  19595395     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The paclitaxel drug-eluting stent (Taxus, Boston Scientific) is FDA approved for treatment of coronary artery disease in simple, noncomplex coronary lesions. In this registry, we sought to investigate the procedural success and long-term outcomes of patients receiving the Taxus stent in the setting of acute ST-elevation myocardial infarction (STEMI) in a busy single-center interventional program. METHODS: This is a single-center retrospective analysis of prospectively collected in-hospital data with postdischarge follow-up achieved by phone calls and review of medical records. Data were audited by an independent monitor, and outcomes were adjudicated by an experienced interventional cardiologist. All patients with STEMI over the period of 2 years (2005 and 2006) with native de novo lesions who received the Taxus stent were included. Patients receiving bare metal stents were excluded. The primary outcome was the combined end point of cardiac death, recurrent nonfatal MI, and target lesion revascularization (TLR) on follow-up. RESULTS: Of 198 patients included in this study, follow-up data were obtained in 172 (86.9%) patients. The mean age was 63+/-14.9 years. There were 59.1% males. Patients had the following cardiac risk factors: diabetes 20.7%, hypertension 60.6%, hyperlipidemia 87.8%, and current smoking 48%. In-hospital complications included death 5.1%, acute closure with stent thrombosis 1%, vascular complications 2.9%, and cardiogenic shock 6.6%. The mean follow-up period (days) was 317.3+/-239.3. The primary end point of cardiac death, nonfatal MI, and TLR was met in 12.4%. Individual end points on follow-up were cardiac death 2.5%, total death 4.9%, TLR 8.1%, target vessel revascularization 19.9%, stroke 1.2%, nonfatal MI 5%, and acute stent thrombosis 5.5% (definite 4.3%, probable 0.6%, possible 0.6%; Academic Research Consortium definition). CONCLUSION: The use of the Taxus stent in acute STEMI is associated with a low postdischarge combined end point of cardiac death, nonfatal MI, and TLR and a definite/probable 4.9% in-stent thrombosis rate, which is within the reported range of data published in "real-world" registry.
Authors:
Nicolas W Shammas; Gail A Shammas; Alex Hahn; Michael Jerin; Eric J Dippel; Matthew Winter
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cardiovascular revascularization medicine : including molecular interventions     Volume:  10     ISSN:  1878-0938     ISO Abbreviation:  -     Publication Date:    2009 Jul-Sep
Date Detail:
Created Date:  2009-07-14     Completed Date:  2009-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101238551     Medline TA:  Cardiovasc Revasc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  151-5     Citation Subset:  IM    
Affiliation:
Midwest Cardiovascular Research Foundation, Cardiovascular Medicine, PC, Davenport, Iowa 52803, USA. shammas@mchsi.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*,  instrumentation*,  mortality
Cardiovascular Agents / administration & dosage*
Drug-Eluting Stents*
Female
Hospital Mortality
Humans
Male
Middle Aged
Myocardial Infarction / mortality,  therapy*
Paclitaxel / administration & dosage*
Prosthesis Design
Recurrence
Registries
Retrospective Studies
Shock, Cardiogenic / etiology
Stroke / etiology
Thrombosis / etiology
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Cardiovascular Agents; 33069-62-4/Paclitaxel

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


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