A Randomized comparison between everolimus-eluting stent and cobalt chromium stent in patients with acute ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention using routine intravenous eptifibatide: The X-MAN (X ience vs M ulti-Link stent in a cute myocardial infarctio n) trial, a pilot study

Surya Dharma, Alexander J. Wardeh, Sunarya Soerianata, Isman Firdaus, J. Wouter Jukema

Research output: Contribution to journalArticle

Abstract

The objective of this study is to determine the efficacy and safety of an everolimus-eluting stent (EES/Xience; Abbott Vascular, Santa Clara, CA) compared with a cobalt chromium stent (CoCr/Multi-Link Vision; Abbott Vascular) in patients with acute ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) with routine administration of eptifibatide infusion. This is a prospective, single center, randomized trial comparing EES (n=75) and CoCr stent (n=75) implantation in patients with acute STEMI undergoing primary PCI. Intravenous eptifibatide administration was mandatory by protocol in this pilot study. The primary efficacy endpoint was major adverse cardiac events (MACE) at 30 days, defined as the composite of death, reinfarction, and target vessel revascularization. Secondary safety endpoints were stent thrombosis at 30 days and in-hospital bleeding event. Acute reperfusion parameters were also assessed. One-month MACE rate did not differ between EES and CoCr group (1.3 vs. 1.3%, p=1.0). No stent thrombosis cases were observed in the EES group. The groups did not differ with respect to in-hospital bleeding events (5 vs. 9%, p=0.37), achievement of final thrombolysis in myocardial infarction flow 2 or 3 (p=0.21), achievement of myocardial blush grade 2 or 3 (p=0.45), creatine kinase-MB level at 8 to 12 hours after stenting (p=0.29), and left ventricular ejection fraction (p=0.21). This pilot study demonstrates that after one-month follow-up, the use of EES is as safe and effective as the use of CoCr stents in patients with acute STEMI undergoing primary PCI with routine administration of intravenous eptifibatide.

Original languageEnglish
Pages (from-to)93-100
Number of pages8
JournalInternational Journal of Angiology
Volume23
Issue number2
DOIs
Publication statusPublished - 1 Jan 2014

Keywords

  • cobalt chromium
  • eptifibatide
  • everolimus
  • primary PCI
  • STEMI
  • stent

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