PMID- 22324820
OWN - NLM
STAT- MEDLINE
DCOM- 20120911
LR  - 20161125
IS  - 1540-8183 (Electronic)
IS  - 0896-4327 (Linking)
VI  - 25
IP  - 2
DP  - 2012 Apr
TI  - Long-term safety and effectiveness of drug-eluting stents compared to bare metal 
      stents in ST elevation myocardial infarction: findings from the Guthrie Health 
      Off-label Stent (GHOST) Registry.
PG  - 118-25
LID - 10.1111/j.1540-8183.2011.00703.x [doi]
AB  - BACKGROUND: Multiple randomized trials and observational studies have shown 
      drug-eluting stents (DES) to be safe and effective at 3-year follow-up in stent 
      thrombosis (ST)-segment elevation myocardial infarction (STEMI) treated with 
      primary percutaneous coronary intervention (PCI). However, outcomes data beyond 
      3-4 years after DES implantation are sparse. METHODS: We studied 554 STEMI 
      patients who underwent successful PCI with either DES or bare metal stent (BMS). 
      Primary study end-points were time to occurrence of ST and the composite of death 
      or myocardial infarction (MI). Secondary end-points were time to occurrence of 
      major adverse cardiac events (MACEs) and discrete events that comprise MACE 
      (death, MI, and target vessel revascularization [TVR]). Outcomes of the DES and 
      BMS groups were assessed by survival analysis and multivariable Cox regression. 
      RESULTS: There were 205 (37%) patients who received DES and 349 (63%) patients 
      who received BMS. At a median follow-up of 41.4 months after PCI, there were no 
      differences in the unadjusted incidence of ST (ST, 3.4 vs. 4.3%, log-rank P = 
      0.61) and MI (6.8% vs. 8%, P = 0.61) between DES versus BMS groups, respectively. 
      However, DES implantation was associated with lower unadjusted incidence of death 
      or MI (11% vs. 23.5%, P = 0.0002), MACE (16% vs. 34%, P < 0.0001), death (6.3% 
      vs. 17%, P = 0.0004), and TVR (9.8% vs. 18%, P = 0.008) than BMS implantation. In 
      multivariable analyses, DES implantation was associated with significantly lower 
      incidence of MACE (adjusted HR = 0.47 [95% CI: 0.31-0.76], P = 0.0007) than BMS 
      implantation. CONCLUSION: In our study of STEMI patients, DES implantation was 
      safer than BMS implantation and was associated with lower MACE at long-term 
      follow-up.
CI  - (c)2012, Wiley Periodicals, Inc.
FAU - Sattur, Sudhakar
AU  - Sattur S
AD  - Guthrie Clinic, Sayre, Pennsylvania 18840, USA.
FAU - Orshaw, Pam
AU  - Orshaw P
FAU - Boura, Judy
AU  - Boura J
FAU - Harjai, Kishore J
AU  - Harjai KJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20120210
PL  - United States
TA  - J Interv Cardiol
JT  - Journal of interventional cardiology
JID - 8907826
SB  - IM
MH  - Aged
MH  - Coronary Angiography
MH  - *Drug-Eluting Stents
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Myocardial Infarction/diagnostic imaging/*therapy
MH  - Registries
MH  - *Stents
MH  - Treatment Outcome
EDAT- 2012/02/14 06:00
MHDA- 2012/09/12 06:00
CRDT- 2012/02/14 06:00
PHST- 2012/02/14 06:00 [entrez]
PHST- 2012/02/14 06:00 [pubmed]
PHST- 2012/09/12 06:00 [medline]
AID - 10.1111/j.1540-8183.2011.00703.x [doi]
PST - ppublish
SO  - J Interv Cardiol. 2012 Apr;25(2):118-25. doi: 10.1111/j.1540-8183.2011.00703.x. 
      Epub 2012 Feb 10.