PMID- 23578890
OWN - NLM
STAT- MEDLINE
DCOM- 20141222
LR  - 20131014
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 168
IP  - 3
DP  - 2013 Oct 3
TI  - Predictors and clinical implications of stent thrombosis in patients with 
      ST-segment elevation myocardial infarction: Insights from the EXAMINATION trial.
PG  - 2632-6
LID - S0167-5273(13)00455-5 [pii]
LID - 10.1016/j.ijcard.2013.03.036 [doi]
AB  - BACKGROUND: Few data are available about safety of second generation drug eluting 
      stents in an all-comer ST elevation myocardial infarction (STEMI) population. We 
      sought to investigate the predictors and clinical implications of 1-year stent 
      thrombosis (ST) in patients with STEMI, included in the EXAMINATION trial. 
      METHODS AND RESULTS: The EXAMINATION trial is an all-comer prospective, 
      randomized 1:1 controlled trial, testing everolimus-eluting stent (EES) vs. 
      cobalt chromium bare metal stent (BMS) in STEMI patients. It included 1498 
      patients, randomized to EES (n = 751) or BMS (n = 747). At 1 year, 
      definite/probable stent thrombosis, defined according to ARC criteria, occurred 
      in 26 patients (1.73%), including 18 definite and 8 probable events. The 
      incidence of ST was lower in patients treated with EES than in those treated with 
      BMS (HR 0.16, 95% CI 0.03-0.29, p = 0.017). Patients with ST have higher 1-year 
      rates of cardiac death (30.8% vs. 2.5%, p<0.001), myocardial infarction (30.8% 
      vs. 0.5%, p<0.001) and target vessel revascularization (65.4% vs. 4.2%, p<0.001) 
      compared with those without. Independent predictors of 1-year definite/probable 
      ST were BMS implantation at the index procedure (HR 3.41, 95% CI 1.35-8.60), ST 
      segment resolution of at least 70% in the EKG post-PCI (HR 0.30, 95% CI 
      0.13-0.70) and Killip class on admission (HR 2.57, 95% CI 1.70-3.90). 
      CONCLUSIONS: ST had low frequency in the first year after implantation of EES/BMS 
      in STEMI patients, but it is associated with adverse events. BMS implantation, 
      lack of ST-segment resolution and high Killip class on admission were independent 
      predictors of 1-year ST.
CI  - Copyright (c) 2013 Elsevier Ireland Ltd. All rights reserved.
FAU - Brugaletta, Salvatore
AU  - Brugaletta S
AD  - University Hospital Clinic, IDIBAPS, Barcelona, Spain.
FAU - Sabate, Manel
AU  - Sabate M
FAU - Martin-Yuste, Victoria
AU  - Martin-Yuste V
FAU - Masotti, Monica
AU  - Masotti M
FAU - Shiratori, Yoshitaka
AU  - Shiratori Y
FAU - Alvarez-Contreras, Luis
AU  - Alvarez-Contreras L
FAU - Cequier, Angel
AU  - Cequier A
FAU - Iniguez, Andres
AU  - Iniguez A
FAU - Serra, Antonio
AU  - Serra A
FAU - Hernandez-Antolin, Rosana
AU  - Hernandez-Antolin R
FAU - Mainar, Vicente
AU  - Mainar V
FAU - Valgimigli, Marco
AU  - Valgimigli M
FAU - Tespili, Maurizio
AU  - Tespili M
FAU - den Heijer, Pieter
AU  - den Heijer P
FAU - Bethencourt, Armando
AU  - Bethencourt A
FAU - Vazquez, Nicolas
AU  - Vazquez N
FAU - Gomez-Lara, Josep
AU  - Gomez-Lara J
FAU - Backx, Bianca
AU  - Backx B
FAU - Serruys, Patrick W
AU  - Serruys PW
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20130408
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
MH  - Drug-Eluting Stents/*adverse effects
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/physiopathology/*therapy
MH  - Prospective Studies
MH  - Single-Blind Method
MH  - Thrombosis/*etiology
OTO - NOTNLM
OT  - Everolimus-eluting stent
OT  - STEMI
OT  - Stent thrombosis
EDAT- 2013/04/13 06:00
MHDA- 2014/12/23 06:00
CRDT- 2013/04/13 06:00
PHST- 2012/12/02 00:00 [received]
PHST- 2013/02/07 00:00 [revised]
PHST- 2013/03/17 00:00 [accepted]
PHST- 2013/04/13 06:00 [entrez]
PHST- 2013/04/13 06:00 [pubmed]
PHST- 2014/12/23 06:00 [medline]
AID - S0167-5273(13)00455-5 [pii]
AID - 10.1016/j.ijcard.2013.03.036 [doi]
PST - ppublish
SO  - Int J Cardiol. 2013 Oct 3;168(3):2632-6. doi: 10.1016/j.ijcard.2013.03.036. Epub 
      2013 Apr 8.