PMID- 28865897 OWN - NLM STAT- MEDLINE DCOM- 20180604 LR - 20180604 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 248 DP - 2017 Dec 1 TI - Bare metal versus drug eluting stents for ST-segment elevation myocardial infarction in the TOTAL trial. PG - 120-123 LID - S0167-5273(17)33508-8 [pii] LID - 10.1016/j.ijcard.2017.06.070 [doi] AB - BACKGROUND: The safety and efficacy of drug eluting stents (DES) in the setting of ST elevation myocardial infarction (STEMI) is not well established. METHODS: In the TOTAL trial, patients presenting with STEMI were randomized to routine thrombectomy versus PCI alone. In this post-hoc analysis, propensity matching was used to assess relative safety and efficacy according to type of stent used. RESULTS: Each propensity-matched cohort included 2313 patients. The composite primary outcome of cardiovascular death, recurrent MI, cardiogenic shock or class IV heart failure within one year was lower in the DES group (HR 0.67; 95% CI 0.54 to 0.84, p=0.0004). Cardiovascular death (HR 0.61; 95% CI 0.43 to 0.86, p=0.005), recurrent MI (HR 0.51; 95% CI 0.35 to 0.75, p=0.0005), target vessel revascularization (HR 0.47; 95% CI 0.36 to 0.62, p<0.0001) and stent thrombosis (HR 0.60; 95% CI 0.40 to 0.89, p=0.01) were lower in the DES group. There was no difference in major bleeding between groups. CONCLUSIONS: In this observational analysis, the use of DES was associated with improvement in cardiovascular outcomes compared to the use of BMS. These results support the use of DES during primary PCI for STEMI. CI - Copyright (c) 2017 Elsevier Ireland Ltd. All rights reserved. FAU - Lavi, Shahar AU - Lavi S AD - London Health Sciences Centre, Western University, London, ON, Canada. Electronic address: Shahar.lavi@lhsc.on.ca. FAU - Iqbal, Javaid AU - Iqbal J AD - South Yorkshire Cardiothoracic Centre, Sheffield, UK. Electronic address: J.Iqbal@sheffield.ac.uk. FAU - Cairns, John A AU - Cairns JA AD - Department of Medicine, University of British Columbia, Vancouver, BC, Canada. Electronic address: John.Cairns@ubc.ca. FAU - Cantor, Warren J AU - Cantor WJ AD - Southlake Regional Health Centre, Newmarket, University of Toronto, ON, Canada. Electronic address: Cantorw@rogers.com. FAU - Cheema, Asim N AU - Cheema AN AD - St. Michael's Hospital, Toronto, ON, Canada. Electronic address: Cheemaa@smh.ca. FAU - Moreno, Raul AU - Moreno R AD - University Hospital La Paz, Madrid, Spain. FAU - Meeks, Brandi AU - Meeks B AD - The Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada. Electronic address: Brandi.Meeks@phri.ca. FAU - Welsh, Robert C AU - Welsh RC AD - Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada. Electronic address: Robert.Welsh@albertahealthservices.ca. FAU - Kedev, Sasko AU - Kedev S AD - University Clinic of Cardiology, Medical Faculty, University of St. Cyril & Methodius, Skopje, Macedonia. FAU - Chowdhary, Saqib AU - Chowdhary S AD - University Hospital of South Manchester, Manchester, United Kingdom. Electronic address: Saqib.Chowdhary@uhsm.nhs.uk. FAU - Stankovic, Goran AU - Stankovic G AD - Clinical Center of Serbia, Department of Cardiology, Medical Faculty, University of Belgrade, Belgrade, Serbia. FAU - Schwalm, J D AU - Schwalm JD AD - The Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada. Electronic address: schwalj@mcmaster.ca. FAU - Liu, Yan AU - Liu Y AD - The Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada. Electronic address: yanyun.liu@phri.ca. FAU - Jolly, Sanjit S AU - Jolly SS AD - The Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada. Electronic address: Sanjit.Jolly@phri.ca. FAU - Dzavik, Vladimir AU - Dzavik V AD - Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada. Electronic address: Vlad.Dzavik@uhn.ca. LA - eng PT - Comparative Study PT - Journal Article PT - Observational Study PT - Randomized Controlled Trial DEP - 20170830 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 RN - 0 (Metals) SB - IM CIN - Int J Cardiol. 2017 Dec 1;248:124-125. PMID: 28724504 MH - Aged MH - Cohort Studies MH - Drug-Eluting Stents/adverse effects/*trends MH - Female MH - Humans MH - Male MH - *Metals/adverse effects MH - Middle Aged MH - Percutaneous Coronary Intervention/adverse effects/instrumentation/*trends MH - ST Elevation Myocardial Infarction/diagnostic imaging/*mortality/*surgery MH - Stents/adverse effects/trends MH - Thrombosis/diagnostic imaging/etiology/mortality OTO - NOTNLM OT - Bare metal stent OT - Drug-eluting stent OT - STEMI EDAT- 2017/09/04 06:00 MHDA- 2018/06/05 06:00 CRDT- 2017/09/04 06:00 PHST- 2017/06/13 00:00 [received] PHST- 2017/06/15 00:00 [accepted] PHST- 2017/09/04 06:00 [pubmed] PHST- 2018/06/05 06:00 [medline] PHST- 2017/09/04 06:00 [entrez] AID - S0167-5273(17)33508-8 [pii] AID - 10.1016/j.ijcard.2017.06.070 [doi] PST - ppublish SO - Int J Cardiol. 2017 Dec 1;248:120-123. doi: 10.1016/j.ijcard.2017.06.070. Epub 2017 Aug 30.