lua chon stent thuong hay stent phu thuoc

Lüscher, Bernhard Meier, Stephan Windecker, Peter Jüni Comparison of drug-eluting stents with bare metal stents in patients with ST-segment elevation myocardial infarction 15 RCT 2012 A

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Can thiệp cấp cứu động mạch vành: lựa chọn stent trần hay stent phủ thuốc

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TS Nguyễn Cửu Lợi Trung tâm Tim mạch – Bệnh viện Trung Ương Huế

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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

• 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

• Follow-up at 5 years

Paclitaxel-Eluting Versus Conventional Stent in Myocardial Infarction with ST-Segment Elevation [ PASSION ]

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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

J Am Coll Cardiol Intv 2011;4:24–9

Paclitaxel-Eluting Versus Conventional Stent in Myocardial Infarction with ST-Segment Elevation [PASSION]

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Ev

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- 3980 (63.2%) DES (99% PES & SES)

- 2318 (36.8%) BMS

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Bindu Kalesan, Thomas Pilgrim, Katja Heinimann, Lorenz Räber, Giulio G Stefanini, Marco Valgimigli, Bruno R da Costa, François Mach, Thomas F Lüscher, Bernhard Meier, Stephan Windecker, Peter Jüni

Comparison of drug-eluting stents with bare metal stents in patients with ST-segment elevation myocardial infarction (15 RCT)

2012 Apr;33(8):977-87

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Comparison of drug-eluting stents with bare metal stents in patients with ST-segment elevation myocardial infarction (cont’)

Overall

Year 1

Subsequent year

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Overall

Year 1

Subsequent year

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Bindu Kalesan, Thomas Pilgrim, Katja Heinimann, Lorenz Räber, Giulio G Stefanini, Marco Valgimigli, Bruno R da Costa, François Mach, Thomas F Lüscher, Bernhard Meier, Stephan Windecker, Peter Jüni

CONCLUSION

An early benefit of early generation DES in primary

PCI for STEMI with a reduction in TVR and a trend

towards less definite ST is offset in subsequent years

by an increased risk of very late ST

Comparison of drug-eluting stents with bare metal stents in patients with ST-segment

elevation myocardial infarction (cont’)

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Paclitaxel-Eluting Stents versus Bare-Metal Stents

in Acute Myocardial Infarction

Gregg W Stone, M.D., Alexandra J Lansky, M.D., Stuart J Pocock, Ph.D.,

Bernard J Gersh, M.B., Ch.B., D.Phil., George Dangas, M.D., Ph.D., S Chiu Wong, M.D., Bernhard Witzenbichler, M.D., Giulio Guagliumi, M.D., Jan Z Peruga, M.D., Bruce R Brodie, M.D., Dariusz Dudek, M.D., Martin Möckel, M.D., Andrzej Ochala, M.D., Alison Kellock, B.S., Helen Parise, Sc.D., and

Roxana Mehran, M.D for the HORIZONS-AMI Trial Investigators

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Stone GW et al N Engl J Med 2009;360:1946-1959

Kaplan–Meier Time-to-Event Curves for Primary End Points and Three Components of the Primary Composite Safety End Point

HR, 0.59; 95% CI, 0.43 to 0.83; P=0.002 HR, 1.02; 95% CI, 0.76 to 1.36; P=0.01

HR, 0.97; 95% CI, 0.70 to 1.32; P=0.83 HR, 0.93; 95% CI, 0.59 to 1.47; P=0.77

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Drug-Eluting Stents Versus Bare-Metal Stents in Diabetic Patients

With ST-Segment Elevation Acute Myocardial Infarction: A Pooled Analysis of Individual Patient Data From Seven Randomized Trials

Rev Esp Cardiol 2009;62(04):354-64

Raisuke Iijimaa, Robert A Byrnea, Alban Dibraa, Gjin Ndrepepaa, Christian

Spauldingb, Gerrit J Laarmanc, Maurizio Menichellid, Marco Valgimiglie, Emilio

Di Lorenzof, Christoph Kaiserg, Ilkka Tieralah, Julinda Mehillia, Maarten J

Suttorpi, Roberto Violinid, Albert Schömiga, Adnan Kastratia

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Drug-Eluting Stents Versus Bare-Metal Stents in Diabetic Patients With ST-Segment

Elevation Acute Myocardial Infarction: A Pooled Analysis of Individual Patient Data From Seven Randomized Trials

Rev Esp Cardiol 2009;62(04):354-64

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Rev Esp Cardiol 2009;62(04):354-64

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Rev Esp Cardiol 2009;62(04):354-64

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Rev Esp Cardiol 2009;62(04):354-64

CONCLUSIONS

In conclusion, use of DES in diabetic patients

undergoing primary stenting for STEMI reduces the

need for repeat intervention without increasing the

rate of thrombosis-related events as compared to

BMS

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HỘI NGHỊ TIM MẠCH CAN THIỆP

26-27/03/2016

TP Huế

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