EXAMINATION

1
EXAMINATION

• Objective
• Assess the safety and performance of a
  new-generation DES vs. a BMS in the setting of
  primary PCI for treatment of patients with STEMI
• Study Design
• Multicenter, multinational, prospective,
  randomized, two-arm, single-blind, controlled
• 1504 patients (all comers) who presented with
  STEMI within 48 hours of symptom onset, required
  emergent PCI, and had a target vessel diameter
  sufficient to accommodate currently available
  stents, randomized to receive an
  everolimus-eluting stent or a cobalt-chromium
  stent
• Primary Endpoint
• Composite endpoint of all-cause death, any MI,
  any revascularization

2
EXAMINATION

• Secondary Endpoints (at 1 year and yearly up to 5
  years)
• All-cause and cardiac mortality
• Recurrent MI
• TLR and TVR
• Clinical device and procedure success
• Major and minor bleeding
• 1-Year Results
• A similar proportion of patients in the DES and
  BMS groups remainedfree from the primary
  endpoint
• Several individual endpoints were also similar,
  including freedom fromcardiac death, recurrent
  MI, and repeat revascularization

3
EXAMINATION
Primary Endpoint Composite endpoint of all-cause
death, any MI, any revascularization
4
EXAMINATION

• Conclusions
• These results support the 2010 ESC guideline
  preference for DES over BMS in patients who have
  no contraindications to prolonged dual
  antiplatelet therapy
• The observation of a reduction in definite and
  definite/probable stent thrombosis in this
  modestly powered single-blind (subject) trial
  requires validation
• In applying results to clinical practice, it
  should be noted that there was high utilization
  (90) of dual antiplatelet therapy through 1 year