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Systematic review and meta-analysis

This trial is included in the following systematic reviews and meta-analyses:

acute myocardial infarction - myocardial revascularization - all type of patients

acute myocardial infarction - PCI - all type of patients


Related trials

TRIANA, 2009 - primary ballon angioplasty vs tenecteplase

DEBATER (SES vs BMS), 2009 - sirolimus eluting stent vs bare-metal stent

NORDISTEMI, 2009 - thrombolysis + angioplasty vs immediate thrombolysis

Juwana, 2009 - sirolimus eluting stent vs paclitaxel eluting stent

ZEST AMI (vs PES), 2009 - zotarolimus eluting stent vs paclitaxel eluting stent

PASEO, 2009 - drug-eluting stents vs bare-metal stent

ZEST AMI (vs SES), 2009 - zotarolimus eluting stent vs sirolimus eluting stent

CARESS, 2008 - thrombolysis + angioplasty vs immediate thrombolysis

HORIZONS-AMI Stent, 2008 - paclitaxel eluting stent vs bare-metal stent

MISSION, 2008 - sirolimus eluting stent vs bare-metal stent

DEDICATION, 2008 - drug-eluting stents vs bare-metal stent

D�az de la Llera, 2007 - sirolimus eluting stent vs bare-metal stent

SESAMI, 2007 - sirolimus eluting stent vs bare-metal stent

PROSIT, 2006 - sirolimus eluting stent vs paclitaxel eluting stent

HAAMU-STENT, 2006 - paclitaxel eluting stent vs bare-metal stent

PASSION, 2006 - paclitaxel eluting stent vs bare-metal stent

WEST, 2006 - systematic PCI (+stent) vs no systematic PCI

TYPHOON, 2006 - sirolimus eluting stent vs bare-metal stent

ZWOLLE 6, 2005 - primary stenting vs balloon angioplasty

CAPITAL AMI, 2005 - systematic PCI (+stent) vs no systematic PCI

senior PAMI, 2005 - primary PCI vs Thrombolysis

CAPITAL AMI, 2005 - thrombolysis + angioplasty vs immediate thrombolysis

Di Lorenzo et al., 2005 - sirolimus eluting stent vs paclitaxel eluting stent

GRACIA-1, 2004 - systematic PCI (+stent) vs no systematic PCI

MERLIN (Sutton), 2004 - immediate systematic ballon angioplastyte vs no immediate angioplasty



See also:

  • All acute myocardial infarction clinical trials
  • All clinical trials of PCI
  • All clinical trials of sirolimus eluting stent
    		•  

    Juwana study, 2009

    [ISRCTN90526229] Facebook    pdf : sirolimus eluting stent - myocardial revascularization for acute myocardial infarction

    Treatments

    Studied treatment sirolimus coated Cypher stent
    Control treatment paclitaxel coated Taxus stent

    Patients

    Patients patients with STEMI undergoing primary PCI
    Inclusion criteria patients with STEMI within 6 hours after symptom onset or between 6 to 24 hours with persistent chest pain associated with clinical evidence of ongoing ischemia; culprit lesion in a native coronary artery, suitable for stenting, with a lesion length 30 mm and a vessel diameter 2.5 mm
    Exclusion criteria women of child-bearing potential, patients with severe hepatic or renal disease, previous participation in the study, life expectancy 1 year, factors making follow-up difficult, pretreatment with thrombolysis, unprotected left main coronary artery disease or single remaining vessel, target lesion in a bifurcation with a large side branch, known sensitivity to aspirin, clopidogrel, or coumarin
    Baseline characteristics
    age 61 y 
    diabetes (%) 8.6% 
    Smoker (%) 50% (current) 
    LAD (%) 42% 
    RCA (%) 41% 
    LCx (%) 15.9% 
    lesion length (mm) 23.24 mm 
    male (%) 72% 
    reference-vessel diameter 3.2 mm 
    STEMI 100� 
    multi vessels patients 34.5% 

    Method and design

    Randomized effectives 196 / 201 (studied vs. control)
    Design Parallel groups
    Blinding open
    Follow-up duration 9 months (12 months)
    Number of centre single center
    Geographic area The Netherlands
    Primary endpoint late lumen loss


    Results

    Endpoint Studied treat.
    n/N     Control treat.
    n/N     Graph RR [95% CI]

    MACE

    19 / 196
         19 / 201
         1,03 [0,56;1,88]

    All cause death

    7 / 196
         5 / 201
         classic 1,44 [0,46;4,45]

    MI (fatal and non fatal)

    6 / 196
         6 / 201
         classic 1,03 [0,34;3,13]

    target-vessel revascularization

    11 / 196
         13 / 201
         0,87 [0,40;1,89]     0 2 1.0

    Relative risks
    Endpoint Events (%) Relative Risk 95% CI Endpoint definition
    in the trial    		 Ref
    Studied treat. Control treat.
    MACE 19 / 196 (9,7%) 19 / 201 (9,5%) 1,03 [0,56;1,88]    
    All cause death 7 / 196 (3,6%) 5 / 201 (2,5%) 1,44 [0,46;4,45]    
    MI (fatal and non fatal) 6 / 196 (3,1%) 6 / 201 (3,0%) 1,03 [0,34;3,13]    
    target-vessel revascularization 11 / 196 (5,6%) 13 / 201 (6,5%) 0,87 [0,40;1,89]    
    The primary endpoint (if exists) appears in blod characters
    Reference(s) used for data extraction:

    Endpoint studied treat. control treat. mean diff

    Absolute risk reduction
    Endpoint Events rate Absolute risk
    reduction (ARR)
    Studied treat. Control treat.
    MACE 9,69% 9,45% 2,4‰
    All cause death 3,57% 2,49% 1,1%
    MI (fatal and non fatal) 3,06% 2,99% 0,8‰
    target-vessel revascularization 5,61% 6,47% -8,6‰

    Meta-analysis of all similar trials:

    myocardial revascularization in acute myocardial infarction for all type of patients

    PCI in acute myocardial infarction for all type of patients



    Reference(s)

    Trials register # ISRCTN90526229
    • Juwana YB, Suryapranata H, Ottervanger JP, De Luca G, van't Hof AW, Dambrink JH, de Boer MJ, Gosselink AT, Hoorntje JC. Comparison of rapamycin- and paclitaxel-eluting stents in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction.. Am J Cardiol 2009;104:205-9
      Pubmed | Hubmed | Fulltext

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