A1 Refereed original research article in a scientific journal
Five-year clinical outcome of titanium-nitride-oxide-coated bioactive stents versus paclitaxel-eluting stents in patients with acute myocardial infarction – Long-term follow-up from the TITAX AMI trial
Subtitle: Long-term follow-up from the TITAX AMI trial
Authors: Tuomainen PO, Ylitalo A, Niemela M, Kervinen K, Pietila M, Sia J, Nyman K, Nammas W, Airaksinen KEJ, Karjalainen PP
Publisher: ELSEVIER IRELAND LTD
Publishing place: CLARE; ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND
Publication year: 2013
Journal: International Journal of Cardiology
Journal name in source: International journal of cardiology
Journal acronym: Int.J.Cardiol.
Number in series: 2
Volume: 168
Issue: 2
First page : 1214
Last page: 1219
Number of pages: 6
ISSN: 0167-5273
DOI: https://doi.org/10.1016/j.ijcard.2012.11.060(external)
Background: The TITAX-AMI randomized controlled trial demonstrated a better clinical outcome with titanium-nitride-oxide-coated bioactive stents (BAS) as compared with paclitaxel-eluting stents (PES) at 2-year follow-up, in patients with acute myocardial infarction (MI) undergoing early percutaneous coronary intervention (PCI). We sought to present the 5-year clinical outcome of the TITAX-AMI trial. Methods: A total of 425 patients with acute MI were randomly assigned to receive either BAS (214), or PES (211). The primary endpoint was major adverse cardiac events (MACE): a composite of cardiac death, recurrent MI or ischemia-driven target lesion revascularization (TLR). Clinical follow-up was performed to 5 years. Results: The 5-year cumulative incidence of MACE was significantly lower in patients assigned to BAS as compared with those assigned to PES (16.4% versus 25.1%, respectively, p = 0.03). Similarly, the 5-year rates of cardiac death and recurrent MI were significantly lower in patients assigned to BAS (1.9% versus 5.7%, and 8.4% versus 18.0%, p = 0.04 and p = 0.004, respectively). Yet, the rates of ischemia-driven TLR were similar between the two study groups (11.2% versus 10.9%, respectively, p = 0.92). The rate of definite stent thrombosis (ST) was again significantly lower in patients assigned to BAS (0.9% versus 7.1%, respectively, p = 0.001). Conclusions: In the current prospective randomized TITAX-AMI trial, among patients presenting with acute MI who underwent early PCI, BAS achieved a better clinical outcome as compared with PES at 5-year follow-up, as reflected by lower cumulative rates of overall MACE, cardiac death, recurrent MI, and definite ST; yet, with statistically similar rates of ischemia-driven TLR.
