Maintenance of long-term clinical benefit with sirolimus-eluting stents in patients with ST-segment elevation myocardial infarction 3-year results of the SESAMI (sirolimus-eluting stent versus bare-metal stent in acute myocardial infarction) trial.

The aim of this study was to investigate whether the reported favorable 1-year outcome of the sirolimus-eluting stent (SES) versus the bare-metal stent (BMS) in the SESAMI (Sirolimus-Eluting Stent Versus Bare-Metal Stent In Acute Myocardial Infarction) trial, in the setting of ST-segment elevation myocardial infarction (STEMI), is maintained at 3-year follow-up. At present, only long-term registry data, but not randomized trials, on the safety and effectiveness of SES in STEMI patients are available. Overall, 320 STEMI patients were randomized to receive SES or BMS. The primary end point was the incidence of major adverse cardiovascular events (MACE), at 3-year follow-up. The secondary end points were the rate of target lesion revascularization (TLR) and target vessel revascularization (TVR) and target vessel failure (TVF). The incidence of late events, starting from clopidogrel withdrawal, was also investigated. The 3-year incidence of MACE was lower in the SES group compared with the BMS group (12.7% vs. 21%, p = 0.034), as were TLR (7% vs. 13.5%, p = 0.048), TVR (8% vs. 16%, p = 0.027), and TVF (11.5% vs. 20.5%, p = 0.028) rates. The 3-year survival rate free from MACE, TLR, and TVF was significantly higher in the SES group than in the BMS group (87%, 93%, and 89.5% vs. 79%, 86.5%, and 79.5%, respectively, p < 0.05). The lower incidence of adverse events in the SES group was driven by TLR reduction and achieved in the first year of follow-up. The cumulative incidence of death and recurrent myocardial infarction, starting from clopidogrel discontinuation, was comparable in the 2 groups. The clinical benefits of SES have been shown to be greater than those of BMS at 3-year follow-up.

Violini R ，Musto C ，De Felice F ，Nazzaro MS ，Cifarelli A ，Petitti T ，Fiorilli R ... -  《-》

Comparison of three-year clinical outcome of sirolimus- and paclitaxel-eluting stents versus bare metal stents in patients with ST-segment elevation myocardial infarction (from the RESEARCH and T-SEARCH Registries).

Daemen J ，Tanimoto S ，García-García HM ，Kukreja N ，van de Sande M ，Sianos G ，de Jaegere PP ，van Domburg RT ，Serruys PW ... -  《AMERICAN JOURNAL OF CARDIOLOGY》

Long-term clinical outcomes and stent thrombosis of sirolimus-eluting versus bare metal stents in patients with end-stage renal disease: results of Korean multicenter angioplasty team (KOMATE) Registry.

Kim BK ，Oh S ，Jeon DW ，Yang JY ，Kim JS ，Park S ，Choi D ，Jang Y ，Hong BK ，Kwon HM ，Lee SW ，Goh CW ，Kwon K ，Ryu SK ，Korean Multicenter Angioplasty Team (KOMATE) Investigators ... -  《-》

5-year clinical outcomes after sirolimus-eluting stent implantation insights from a patient-level pooled analysis of 4 randomized trials comparing sirolimus-eluting stents with bare-metal stents.

Caixeta A ，Leon MB ，Lansky AJ ，Nikolsky E ，Aoki J ，Moses JW ，Schofer J ，Morice MC ，Schampaert E ，Kirtane AJ ，Popma JJ ，Parise H ，Fahy M ，Mehran R ... -  《-》

Long-term outcome of sirolimus-eluting vs bare-metal stent in the setting of acute myocardial infarction: 5-year results of the SESAMI trial.

few long-term randomized data on safety and effectiveness of sirolimus-eluting stent (SES) in the ST-segment elevation myocardial infarction (STEMI) setting are available. The aim of the present investigation was to evaluate the 5-year clinical outcome of SES vs bare-metal stent (BMS) implantation in patients with STEMI. 320 STEMI patients were randomized to receive SES or BMS. The primary end-point was the incidence of target vessel failure (TVF) at 5-year follow-up. The secondary end-points were the rate of target lesion revascularization (TLR), major adverse cardiovascular events (MACE), death or non-fatal MI and stent thrombosis (ST). Event rates from 1 to 5 years in patients undergoing TLR and those TLR free at 1 year were also investigated. The 5-year survival rate free from TVF and TLR was significantly higher in the SES than in the BMS group (85% vs 76% p=0.038; 92% vs 85% p=0.045, respectively). The lower incidence of adverse events was achieved in the first year of follow-up. The cumulative incidence of MACE, death or non-fatal MI and ST was comparable in the 2 groups at 5-year follow-up. Moreover death or MI incidence was 5% in the patients who did not experience TLR within 1-year and 16% in those who experience TLR in the same period (p=0.033). Predictors of death or MI during 5-year follow-up were TLR within 1 year (OR 3.4, 95% CI 1.1-10.1; p=0.04) and small vessels treatment (OR 4.8 95% CI 1.7-13.0; p=0.002). The clinical benefits of SES are maintained up to 5years without safety concerns.

Musto C ，Fiorilli R ，De Felice F ，Patti G ，Nazzaro MS ，Scappaticci M ，Bernardi L ，Violini R ... -  《-》