Abstract 6005: Six Month Clinical Outcome Following the Use of Everolimus-eluting Stents for ST-segment Elevation Myocardial Infarction: Insights from the Xience V Stent Evaluated At Rotterdam Cardiology Hospital (X-SEARCH) Registry
The risks and benefits of drug-eluting stents (DES) in patients with ST-elevation myocardial infarction (STEMI) have recently been under scrutiny, especially since these patients were excluded from the landmark randomised trials. We sought to evaluate the short-term clinical outcomes in patients with STEMI treated with a second generation DES in a real-life all-comer population. Since March 1st 2007, our institution commenced the use of everolimus-eluting stent (EES) as the default strategy for every percutaneous coronary intervention. Between 1st March and 31st October 2007, 255 consecutive patients presenting with de novo STEMI were treated with EES, including those suffering from cardiogenic shock. This group was compared to 3 historical cohorts of consecutive patients; 543 patients treated with bare metal stents (BMS), 188 with sirolimus-eluting stents (SES) and 1022 with paclitaxel-eluting stents (PES). Six-month follow-up on the occurrence of all-cause death, any myocardial infarction (MI), repeat revascularization and stent thrombosis are currently being collected and will be presented at the time of the meeting. Survival information will be obtained from municipal civil registries. Logistic regression analysis and propensity score-adjustment will be used to calculate predictors of adverse events by compensating for potential confounders in the baseline and procedural characteristics. The patients became progressively significantly older (mean age 58 vs. 59 vs. 60 vs. 62 years for BMS, SES, PES and EES) with increasing total stent length (26 vs. 35 vs. 35 vs. 51mm). The clinical results after 1 month are shown in the table⇓. Within the 1st month, there are no significant differences in mortality between BMS, SES, PES and EES when used in unselected patients with STEMI. Data on 6-month mortality and clinical events are currently being collected and will be presented at the time of the meeting.