Drug-eluting versus bare metal stents in patients with st-segment-elevation myocardial infarction: eight-month follow-up in the Drug Elution and Distal Protection in Acute Myocardial Infarction (DEDICATION) trial

Henning Kelbaek; Leif Thuesen; Steffen Helqvist; Peter Clemmensen; Lene Kløvgaard; Anne Kaltoft; Bente Andersen; Helle Thuesen; Thomas Engstrøm; Hans E Bøtker; Kari Saunamäki; Lars R Krusell; Erik Jørgensen; Hans-Henrik T Hansen; Evald H Christiansen; Jan Ravkilde; Lars Køber; Klaus F Kofoed; Christian J Terkelsen; Jens F Lassen; DEDICATION Investigators

doi:10.1161/CIRCULATIONAHA.107.758698

Drug-eluting versus bare metal stents in patients with st-segment-elevation myocardial infarction: eight-month follow-up in the Drug Elution and Distal Protection in Acute Myocardial Infarction (DEDICATION) trial

Henning Kelbaek, Leif Thuesen, Steffen Helqvist, Peter Clemmensen, Lene Kløvgaard, Anne Kaltoft, Bente Andersen, Helle Thuesen, Thomas Engstrøm, Hans E Bøtker, Kari Saunamäki, Lars R Krusell, Erik Jørgensen, Hans-Henrik T Hansen, Evald H Christiansen, Jan Ravkilde, Lars Køber, Klaus F Kofoed, Christian J Terkelsen, Jens F LassenDEDICATION Investigators

Department of Clinical Medicine

73 Citations (Scopus)

Abstract

BACKGROUND: Implantation of drug-eluting stents (DES) limits the rate of coronary restenosis in most patients with coronary artery disease, but data are scarce with regard to their use in patients with ST-segment-elevation myocardial infarction and in connection with distal protection of the microvascular perfusion during primary percutaneous coronary intervention. METHODS AND RESULTS: We randomly assigned 626 patients referred within 12 hours from symptom onset of an ST-elevation myocardial infarction to have a DES or a bare metal stent implanted in the infarct-related lesion with or without distal protection during primary percutaneous coronary intervention. Quantitative coronary angiography was performed during the index treatment and 8 months later. The primary end point was loss of the lumen diameter in the infarct-related lesion induced by neointimal proliferation. Patients were comparable with regard to baseline demographic and angiographic characteristics. The mean late lumen loss was significantly lower in patients treated with a DES (0.06 mm; SD, 0.66 mm) than in patients who had a bare metal stent implanted (0.47 mm; SD, 0.69 mm; P<0.001). The rate of the composite end point of cardiac death, recurrent myocardial infarction, and target lesion revascularization was 8.6% in the DES group versus 14.4% in the bare metal stent group (P=0.03). Cardiac death occurred in 4.2% and 1.6% of the patients (P=0.09) and stent thrombosis occurred in 2.0% and 2.6% (P=0.72), respectively. CONCLUSIONS: Implantation of DES improves the angiographic outcome and need for repeat revascularization without increasing the short-term risk of stent thrombosis but has a tendency to increase cardiac death in patients with ST-segment-elevation myocardial infarction.

Original language	English
Journal	Circulation
Volume	118
Issue number	11
Pages (from-to)	1155-62
Number of pages	7
ISSN	0009-7322
DOIs	https://doi.org/10.1161/CIRCULATIONAHA.107.758698
Publication status	Published - 2008

Access to Document

10.1161/CIRCULATIONAHA.107.758698

Fingerprint

Dive into the research topics of 'Drug-eluting versus bare metal stents in patients with st-segment-elevation myocardial infarction: eight-month follow-up in the Drug Elution and Distal Protection in Acute Myocardial Infarction (DEDICATION) trial'. Together they form a unique fingerprint.

Cite this

Kelbaek, H., Thuesen, L., Helqvist, S., Clemmensen, P., Kløvgaard, L., Kaltoft, A., Andersen, B., Thuesen, H., Engstrøm, T., Bøtker, H. E., Saunamäki, K., Krusell, L. R., Jørgensen, E., Hansen, H-H. T., Christiansen, E. H., Ravkilde, J., Køber, L., Kofoed, K. F., Terkelsen, C. J., ... DEDICATION Investigators (2008). Drug-eluting versus bare metal stents in patients with st-segment-elevation myocardial infarction: eight-month follow-up in the Drug Elution and Distal Protection in Acute Myocardial Infarction (DEDICATION) trial. Circulation, 118(11), 1155-62. https://doi.org/10.1161/CIRCULATIONAHA.107.758698

Drug-eluting versus bare metal stents in patients with st-segment-elevation myocardial infarction: eight-month follow-up in the Drug Elution and Distal Protection in Acute Myocardial Infarction (DEDICATION) trial. / Kelbaek, Henning; Thuesen, Leif; Helqvist, Steffen et al.

In: Circulation, Vol. 118, No. 11, 2008, p. 1155-62.

Research output: Contribution to journal › Journal article › Research › peer-review

Kelbaek, H, Thuesen, L, Helqvist, S, Clemmensen, P, Kløvgaard, L, Kaltoft, A, Andersen, B, Thuesen, H, Engstrøm, T, Bøtker, HE, Saunamäki, K, Krusell, LR, Jørgensen, E, Hansen, H-HT, Christiansen, EH, Ravkilde, J, Køber, L , Kofoed, KF, Terkelsen, CJ, Lassen, JF & DEDICATION Investigators 2008, 'Drug-eluting versus bare metal stents in patients with st-segment-elevation myocardial infarction: eight-month follow-up in the Drug Elution and Distal Protection in Acute Myocardial Infarction (DEDICATION) trial', Circulation, vol. 118, no. 11, pp. 1155-62. https://doi.org/10.1161/CIRCULATIONAHA.107.758698

@article{f534fcd0118411df803f000ea68e967b,

title = "Drug-eluting versus bare metal stents in patients with st-segment-elevation myocardial infarction: eight-month follow-up in the Drug Elution and Distal Protection in Acute Myocardial Infarction (DEDICATION) trial",

abstract = "BACKGROUND: Implantation of drug-eluting stents (DES) limits the rate of coronary restenosis in most patients with coronary artery disease, but data are scarce with regard to their use in patients with ST-segment-elevation myocardial infarction and in connection with distal protection of the microvascular perfusion during primary percutaneous coronary intervention. METHODS AND RESULTS: We randomly assigned 626 patients referred within 12 hours from symptom onset of an ST-elevation myocardial infarction to have a DES or a bare metal stent implanted in the infarct-related lesion with or without distal protection during primary percutaneous coronary intervention. Quantitative coronary angiography was performed during the index treatment and 8 months later. The primary end point was loss of the lumen diameter in the infarct-related lesion induced by neointimal proliferation. Patients were comparable with regard to baseline demographic and angiographic characteristics. The mean late lumen loss was significantly lower in patients treated with a DES (0.06 mm; SD, 0.66 mm) than in patients who had a bare metal stent implanted (0.47 mm; SD, 0.69 mm; P<0.001). The rate of the composite end point of cardiac death, recurrent myocardial infarction, and target lesion revascularization was 8.6% in the DES group versus 14.4% in the bare metal stent group (P=0.03). Cardiac death occurred in 4.2% and 1.6% of the patients (P=0.09) and stent thrombosis occurred in 2.0% and 2.6% (P=0.72), respectively. CONCLUSIONS: Implantation of DES improves the angiographic outcome and need for repeat revascularization without increasing the short-term risk of stent thrombosis but has a tendency to increase cardiac death in patients with ST-segment-elevation myocardial infarction.",

author = "Henning Kelbaek and Leif Thuesen and Steffen Helqvist and Peter Clemmensen and Lene Kl{\o}vgaard and Anne Kaltoft and Bente Andersen and Helle Thuesen and Thomas Engstr{\o}m and B{\o}tker, {Hans E} and Kari Saunam{\"a}ki and Krusell, {Lars R} and Erik J{\o}rgensen and Hansen, {Hans-Henrik T} and Christiansen, {Evald H} and Jan Ravkilde and Lars K{\o}ber and Kofoed, {Klaus F} and Terkelsen, {Christian J} and Lassen, {Jens F} and {DEDICATION Investigators}",

note = "Keywords: Angioplasty, Transluminal, Percutaneous Coronary; Cell Proliferation; Coronary Angiography; Coronary Artery Disease; Coronary Stenosis; Death; Drug-Eluting Stents; Follow-Up Studies; Humans; Myocardial Infarction; Stents; Thrombosis; Treatment Outcome; Tunica Intima",

year = "2008",

doi = "10.1161/CIRCULATIONAHA.107.758698",

language = "English",

volume = "118",

pages = "1155--62",

journal = "Circulation",

issn = "0009-7322",

publisher = "AHA/ASA",

number = "11",

}

TY - JOUR

T1 - Drug-eluting versus bare metal stents in patients with st-segment-elevation myocardial infarction: eight-month follow-up in the Drug Elution and Distal Protection in Acute Myocardial Infarction (DEDICATION) trial

AU - Kelbaek, Henning

AU - Thuesen, Leif

AU - Helqvist, Steffen

AU - Clemmensen, Peter

AU - Kløvgaard, Lene

AU - Kaltoft, Anne

AU - Andersen, Bente

AU - Thuesen, Helle

AU - Engstrøm, Thomas

AU - Bøtker, Hans E

AU - Saunamäki, Kari

AU - Krusell, Lars R

AU - Jørgensen, Erik

AU - Hansen, Hans-Henrik T

AU - Christiansen, Evald H

AU - Ravkilde, Jan

AU - Køber, Lars

AU - Kofoed, Klaus F

AU - Terkelsen, Christian J

AU - Lassen, Jens F

AU - DEDICATION Investigators

N1 - Keywords: Angioplasty, Transluminal, Percutaneous Coronary; Cell Proliferation; Coronary Angiography; Coronary Artery Disease; Coronary Stenosis; Death; Drug-Eluting Stents; Follow-Up Studies; Humans; Myocardial Infarction; Stents; Thrombosis; Treatment Outcome; Tunica Intima

PY - 2008

Y1 - 2008

N2 - BACKGROUND: Implantation of drug-eluting stents (DES) limits the rate of coronary restenosis in most patients with coronary artery disease, but data are scarce with regard to their use in patients with ST-segment-elevation myocardial infarction and in connection with distal protection of the microvascular perfusion during primary percutaneous coronary intervention. METHODS AND RESULTS: We randomly assigned 626 patients referred within 12 hours from symptom onset of an ST-elevation myocardial infarction to have a DES or a bare metal stent implanted in the infarct-related lesion with or without distal protection during primary percutaneous coronary intervention. Quantitative coronary angiography was performed during the index treatment and 8 months later. The primary end point was loss of the lumen diameter in the infarct-related lesion induced by neointimal proliferation. Patients were comparable with regard to baseline demographic and angiographic characteristics. The mean late lumen loss was significantly lower in patients treated with a DES (0.06 mm; SD, 0.66 mm) than in patients who had a bare metal stent implanted (0.47 mm; SD, 0.69 mm; P<0.001). The rate of the composite end point of cardiac death, recurrent myocardial infarction, and target lesion revascularization was 8.6% in the DES group versus 14.4% in the bare metal stent group (P=0.03). Cardiac death occurred in 4.2% and 1.6% of the patients (P=0.09) and stent thrombosis occurred in 2.0% and 2.6% (P=0.72), respectively. CONCLUSIONS: Implantation of DES improves the angiographic outcome and need for repeat revascularization without increasing the short-term risk of stent thrombosis but has a tendency to increase cardiac death in patients with ST-segment-elevation myocardial infarction.

AB - BACKGROUND: Implantation of drug-eluting stents (DES) limits the rate of coronary restenosis in most patients with coronary artery disease, but data are scarce with regard to their use in patients with ST-segment-elevation myocardial infarction and in connection with distal protection of the microvascular perfusion during primary percutaneous coronary intervention. METHODS AND RESULTS: We randomly assigned 626 patients referred within 12 hours from symptom onset of an ST-elevation myocardial infarction to have a DES or a bare metal stent implanted in the infarct-related lesion with or without distal protection during primary percutaneous coronary intervention. Quantitative coronary angiography was performed during the index treatment and 8 months later. The primary end point was loss of the lumen diameter in the infarct-related lesion induced by neointimal proliferation. Patients were comparable with regard to baseline demographic and angiographic characteristics. The mean late lumen loss was significantly lower in patients treated with a DES (0.06 mm; SD, 0.66 mm) than in patients who had a bare metal stent implanted (0.47 mm; SD, 0.69 mm; P<0.001). The rate of the composite end point of cardiac death, recurrent myocardial infarction, and target lesion revascularization was 8.6% in the DES group versus 14.4% in the bare metal stent group (P=0.03). Cardiac death occurred in 4.2% and 1.6% of the patients (P=0.09) and stent thrombosis occurred in 2.0% and 2.6% (P=0.72), respectively. CONCLUSIONS: Implantation of DES improves the angiographic outcome and need for repeat revascularization without increasing the short-term risk of stent thrombosis but has a tendency to increase cardiac death in patients with ST-segment-elevation myocardial infarction.

U2 - 10.1161/CIRCULATIONAHA.107.758698

DO - 10.1161/CIRCULATIONAHA.107.758698

M3 - Journal article

C2 - 18725489

SN - 0009-7322

VL - 118

SP - 1155

EP - 1162

JO - Circulation

JF - Circulation

IS - 11

ER -