- 作者：Maarten A. Vink ; MD?/sup> ; m.a.vink@olvg.nl ; Maurits T. Dirksen ; MD ; PhD?/sup> ; Maarten J. Suttorp ; MD ; PhD&Dagger ; ; Jan G.P. Tijssen ; PhD&dagger ; ; Jeroen van Etten ; MD?/sup> ; Mark S. Patterson ; MBBS ; PhD?/sup> ; Ton Slagboom ; MD?/sup> ; Ferdinand Kiemeneij ; MD ; PhD?/sup> ; Gerrit J. Laarman ; MD ; PhD§ ;
- 关键词：drug-eluting stent ; primary percutaneous coronary intervention ; ST-segment elevation myocardial infarction
- 刊名：JACC: Cardiovascular Interventions
- 出版年：2011
- 出版时间：January 2011
- 年：2011
- 卷：4
- 期：1
- 页码：24-29
- 全文大小：563 K
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]; )