José M de la Torre Hernández1, Fernando Alfonso2, Victoria Martin Yuste3, Angel Sánchez Recalde4, Manuel F Jimenez Navarro5, Armando Pérez de Prado6, Felipe Hernández7, Omar Abdul-Jawad Altisent8, Gerard Roura9, Tamara García Camarero10, Jaime Elizaga11, Ramón Calviño12, Jose Moreu13, Francisco Bosa14, Jesús Jimenez Mazuecos15, José R Ruiz-Arroyo16, Bruno Garcia Del Blanco8, José R Rumoso17. 1. Servicio de Cardiología, Hospital Marqués de Valdecilla, Santander, Cantabria, Spain. Electronic address: he1thj@humv.es. 2. Servicio de Cardiología, Hospital Clínico San Carlos, Madrid, Spain. 3. Servicio de Cardiología, Hospital Clínic, Barcelona, Spain. 4. Servicio de Cardiología, Hospital La Paz, Madrid, Spain. 5. Servicio de Cardiología, Hospital Virgen de la Victoria, Malaga, Spain. 6. Servicio de Cardiología, Hospital de León, León, Spain. 7. Servicio de Cardiología, Hospital 12 de Octubre, Madrid, Spain. 8. Servicio de Cardiología, Hospital Vall d'Hebron, Barcelona, Spain. 9. Servicio de Cardiología, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. 10. Servicio de Cardiología, Hospital Marqués de Valdecilla, Santander, Cantabria, Spain. 11. Servicio de Cardiología, Hospital Gregorio Marañon, Madrid, Spain. 12. Servicio de Cardiología, Hospital de la Coruña, CHUAC, La Coruña, Spain. 13. Servicio de Cardiología, Hospital Virgen de la Salud, Toledo, Spain. 14. Servicio de Cardiología, Hospital Clínico de Tenerife, Santa Cruz de Tenerife, Spain. 15. Servicio de Cardiología, Hospital de Albacete, Albacete, Spain. 16. Servicio de Cardiología, Hospital Clínico Lozano Blesa, Zaragoza, Spain. 17. Servicio de Cardiología, Hospital de Galdakao, Bilbao, Vizcaya, Spain.
Abstract
INTRODUCTION AND OBJECTIVES: We sought to compare the long-term clinical outcome of with ST-segment elevation myocardial infarction treated with paclitaxel-eluting stents or everolimus-eluting stents and the influence of thrombectomy on outcomes. METHODS: The ESTROFA-IM is a multicenter retrospective registry collecting consecutive patients with infarction treated with these stents in 16 centers. Propensity-score matching was performed to select comparable stent groups and comparable groups with and without thrombectomy. RESULTS: After matching patients, 350 treated with everolimus-eluting stents and 350 with paclitaxel-eluting stents were included in the analysis. The clinical and angiographic characteristics were comparable in both groups. The 2-year incidence of death, infarction, and target lesion revascularization was 14.9% for paclitaxel-eluting stents and 11.5% for everolimus-eluting stents (P = .04) and the incidence of definite/probable thrombosis 4.3% and 1.4%, respectively (P = .01). The use of paclitaxel-eluting was an independent predictor for events (hazard ratio = 2.44, 95% confidence interval, 1.28-4.65; P = .006). The benefit of everolimus-eluting stents over paclitaxel-eluting stents regarding stent thrombosis was more evident in the nonthrombectomy subgroup (5.4% vs 1.4%; P = .01). A significant interaction was found in the subgroups with and without thombectomy in the comparison between paclitaxel-eluting stents and everolimus-eluting stents for the end-point of stent thrombosis (P = .039). CONCLUSIONS: The results of this multicenter registry suggest better clinical outcomes with the everolimus-eluting stents in ST-segment elevation myocardial infarction. The lower risk of thrombosis with these stents could be more relevant in the absence of thrombectomy.
INTRODUCTION AND OBJECTIVES: We sought to compare the long-term clinical outcome of with ST-segment elevation myocardial infarction treated with paclitaxel-eluting stents or everolimus-eluting stents and the influence of thrombectomy on outcomes. METHODS: The ESTROFA-IM is a multicenter retrospective registry collecting consecutive patients with infarction treated with these stents in 16 centers. Propensity-score matching was performed to select comparable stent groups and comparable groups with and without thrombectomy. RESULTS: After matching patients, 350 treated with everolimus-eluting stents and 350 with paclitaxel-eluting stents were included in the analysis. The clinical and angiographic characteristics were comparable in both groups. The 2-year incidence of death, infarction, and target lesion revascularization was 14.9% for paclitaxel-eluting stents and 11.5% for everolimus-eluting stents (P = .04) and the incidence of definite/probable thrombosis 4.3% and 1.4%, respectively (P = .01). The use of paclitaxel-eluting was an independent predictor for events (hazard ratio = 2.44, 95% confidence interval, 1.28-4.65; P = .006). The benefit of everolimus-eluting stents over paclitaxel-eluting stents regarding stent thrombosis was more evident in the nonthrombectomy subgroup (5.4% vs 1.4%; P = .01). A significant interaction was found in the subgroups with and without thombectomy in the comparison between paclitaxel-eluting stents and everolimus-eluting stents for the end-point of stent thrombosis (P = .039). CONCLUSIONS: The results of this multicenter registry suggest better clinical outcomes with the everolimus-eluting stents in ST-segment elevation myocardial infarction. The lower risk of thrombosis with these stents could be more relevant in the absence of thrombectomy.